Neonatal Respiratory Distress Syndrome is a common condition in premature newborns. RDS is a complex clinical status, whose symptoms are related to the underdevelopment of the respiratory system of the newborn.
The severity and incidence of this pathology are directly related to the degree of prematurity, and children born before the 28th week of gestation are at greater risk.
Respiratory insufficiency in preterm infants with RDS occurs due to a shortage in the pulmonary surfactant reserve, which helps to create a biofilm that covers the inner walls of the alveoli. The physiological role of the surfactant is to allow the lungs to expand and prevent collapse (atelectasis) during the expiratory phase. The lack of surfactant results in difficulty in breathing, low oxygenation, increased effort and the need for external respiratory support.
The surfactant reserve available in a premature baby is usually very limited compared to that of a full-term newborn and decreases as a result of RDS. When necessary, the administration of exogenous surfactant may relieve the symptoms of the syndrome by completing the endogenous surfactant pool, thereby allowing the biofilm to be replenished.
Sweet; European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2016 Update - Neonatology 2017;111:107–125