Respiratory Distress Syndrome (RDS)-Management Guidelines

Respiratory Distress Syndrome (RDS) also known as Hyaline Membrane Disease occurs almost exclusively in premature infants. Persistent respiratory distress requires a diagnostic and therapeutic approach to optimize outcome and minimize morbidity and mortality. The management of respiratory distress syndrome (RDS) has improved because of the advances in mechanical ventilators, promotion of antenatal steroids, availability of surfactant and overall progress in neonatal intensive care. Intermittent mandatory ventilation still forms the mainstay of assisted ventilation. Newer modes of ventilation have not delivered the results as promised. The present trend is to follow gentle ventilatory strategies accepting higher arterial carbon dioxide and lower oxygen to reduce the incidence of chronic lung disease. The role of antenatal steroids has been established beyond doubt. Surfactant replacement therapy is the standard of care for RDS although beyond the reach of majority in India. Postnatal steroids are out of vogue because of probable links with cerebral palsy and abnormal neurological outcomes.