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RESPIRATORY DISTRESS IN NEONATES

Rahma Betaly Mohammed Al-Ameri , Lama Hameid Almazroei , Mazen Abdullah Saleh Alzaedi , Ahmed Abdulghani Alzaidi , Mayssan Hussein Almalki , Fawwaz Abdulrahman Abdullah Alshafa , Saeed Saad Mohammad Alqahtani , Nouf Mohammad Bajawi , Saqqar Abdulelah Alanazi , Lujain Tarek Hefni , Rahaf Khalid Althomali , Mansour Ali Mansour Alqahtani , Amjad Obaed Saad Alghamdi

Introduction: Respiratory distress is considered a very common in the early neonatal stages. The incidence is estimated to be more than seven percent of newborn infants. There have been many studies conducted that focused on respiratory distress syndrome and chronic lung disease of prematurity in preterm infants however every year a marked number of term-born infants are admitted to neonatal units for treatment of their respiratory distress. Many clinical conditions could lead to respiratory distress in term newborn infants. Clinical conditions like surfactant protein deficiency syndromes or alveolar capillary dysplasia are seldom and there have been many reviews on them. A study showed that a trending in the incidence of respiratory distress of all neonates admitted to neonatal units between 1974 and 2004 relating three possible explanations: an increase in extremely low birth weight infants, modifications in admission guidelines and higher numbers of infants delivered by caesarean section. The effect of elective caesarean sections has particularly grew the incidence of respiratory distress in term infants. This has been established for several years. A study estimated that more than two thousand patients are diagnosed per year that needed neonatal admission for pulmonary diseases following caesarean section prior to the onset of labor in the UK alone. There were 706,248 live births in England and Wales in 2009 and approximately more than ninety percent of these were full term deliveries. Between 1990 and 2002, it is estimated that the admission rate to a busy neonatal unit in England was more than eight percent of all live births. The most common reason for admission was respiratory distress. There is an obvious inverse relationship between gestational age and incidence of respiratory distress most notably by transient tachypnoea of the newborn (TTN) and respiratory distress syndrome (RDS). Aim of work: In this review, we will discuss the most recent evidence regarding respiratory distress syndrome in neonates. Methodology: We did a systematic search for respiratory distress syndrome in neonates using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: We summarized the most common causes of respiratory distress in term infants. TTN and RDS are considered very common particularly in infants delivered after elective caesarean sections however, they have good prognosis. Even delivery at 37 weeks gestation, is linked with higher respiratory morbidity so should be avoided wherever possible. Clinical conditions like pulmonary arterial hypertension that could be primary or secondary to RDS, MAS or CDH will respond in most cases to oxygen therapy, mechanical ventilation including high frequency ventilation, inhaled nitric oxide or inotropes but ECMO should be considered if the respiratory failure does not respond to maximum medical therapy. The early recognition and initiation of appropriate management is important to ensure the optimal outcome for all infants presenting with respiratory distress. Key words: Respiratory Distress Syndrome, Neonates, Presentation, Management.

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