Respiratorisk Distress Syndrom: milepæler i forståelse og behandling

Abstract

Objectives: The aim of this project thesis was to get an overview of the treatment of Respiratory Distress Syndrome among newborns. This literature review will look into the different treatments and important interventions in this development. Background: RDS is the most common cause of breathing difficulties in premature infants and newborns. The condition is usually caused by abnormal respiratory function during the transition from fetal to neonatal life, due to structural and functional lung immaturity. Failure to recognize symptoms and poor treatment is associated with high risk of neonatal mortality and morbidity. Prevention of RDS is a combination of specific interventions to increase the amount of surfactant in the lungs, provide adequate oxygen supply and ventilation, and general supportive care to optimize neonatal metabolism and cardiorespiratory status. In this thesis, prenatal steroids, ventilator support and surfactant therapy are emphasized. Method: Literature searches in PubMed and McMaster PLUS were preformed in the period March to December 2018. Most of the articles used are reviews, and some are individual studies. The historical perspectives are mostly covered in books. Results and conclusion: RDS has over the years become a well-researched disease in neonatal medicine, and today we have great guidelines and methods to treat RDS. It has been an incredible growth in the knowledge of the pathogenesis and the treatment of RDS. Prenatal steroids, ventilation support and surfactant therapy have shown a significant decrease of the incidence, mortality and morbidity of RDS. These treatments even show a nearly 50 % decrease in neonatal mortality. There are still potentials to reduce further complications, like nebulized surfactant and LISA/MIST, so the research still continues.