A diagnosis of respiratory distress syndrome (or hyaline membrane disease or HMD) depends on the results of the following tests:
1. A chest x-ray is the first line of assessment. It exhibits the glass-like appearance of the membrane in a reticulo-granular pattern.
2. A physical examination of the baby to see the appearance, breathing and color of the baby.
3. EKG or an echocardiography recording the electrical signals of the heart shows abnormal betas and rhythms and helps in differential diagnosis.
4. Blood gas analysis which will indicate the amount of decreased O2, increased CO2 and acid in arterial blood.
5. Mother’s medical history especially with respect to diabetes and preterm labor.
Thankfully, treatment options are effective if the diagnosis is correct and on time (within three days of onset of RDS). I have outlined some avenues available to parents and doctors below. However, it must be kept in mind that doctors decide on the line of treatment depending on a number of factors specific to your case, such as weight, health, gestational age of the baby, baby’s tolerance to medications and treatments, mother’s medical history, other doctors and your (the parent’s) opinions.
1. Continuous Positive Air Pressure (CPAP) – The CPAP is a mechanical breathing device that does the breathing for the baby whereby oxygen is delivered under a small amount of pressure through tubes that go into the nostrils of the baby. It automatically pushes oxygen filled air continuously to the airways of the infant so that his/her bronchioles etc remain open and do not collapse or close.
2. Endotracheal tube is sometimes used in the case the situation becomes worse. An external mechanical device is inserted into the trachea or windpipe of the baby to give intermittent breaths.
3. Extracorporeal Membrane Oxygenation is a treatment option, providing oxygenation through an apparatus that imitates the gas exchange process of the lungs to babys who are closer to normal birth weights.
4. Surfactant replacement may be done once the infant is on the respirator.