Surfactant deficienc. We build our lungs in stages like building a house. One of the final stages is the production of a soapy material called surfactant that lines the inside of air sacs & prevents the sacs from deflating after air breathing starts. Infants that are not making enough surfactant to keep air sacs open so many will deflate leading to distress. Assistance is needed until a baby starts making more surfacta.
Deficiency. The rds comes in 2 basic forms. That of premature infants that do not yet make enough surfactant, and the older kid/adult who looses their surfactant during an illness or toxic event. The surfactant helps assure that the bag like alveoli of the lung air exchange does not empty completely like a balloon. If it does, extra pressure is needed to inflate it to allow oxygen exchange.
Yes. With rare exceptions, all babies have the ability to make their own surfactant, even if they have not done so prior to birth. Once born, the surfactant system is activated, even in extremely preterm infants, and they will start to make their own surfactant within several hours. There are rare genetic conditions where the baby can never make their own surfactant.
Yes. The baby is born with surfactant and continue to produce it after delivery. Premature babies have a huge deficiency of it and run into the respiratory distress syndromes, requiring artificial instillation of surfactant via endothracheal tube once or twice shortly after delivery. Some of them can't recover completely and later develop chronic lung disease with poor structured lungs and pulm. Vessels.
Depends... The length of time needed to recover from ARDS depends on the underlying cause. Many things can cause ARDS including infection, pulmonary embolus, cardiac causes, etc. Once the underlying cause is treated, recovery can begin. Patients who recover from ARDS usually face a lengthy recovery process, including some type of rehabilitation so encouraging the patient during this time is needed.
Depends... The speed of recovery from adult respiratory distress syndrome, ards, depends on the underlying cause of the ards. For example, if it is due to infection, the appropriate antibiotics are needed. It will take time for the lung injury to heal, regardless of the cause. Patients who recover from ARDS typically require a lengthy recovery process, including some form of rehabilitation. Patience is key.
When it happends. The frequency of respiratory distress tends to increase as the term of pregnancy decreases, reaching about 50% before 36 wks in males. It can occur in term babies, particularly diabetic mothers & I have seen some 30 wk premi's that never had it. Other conditions like lung fluid retention, amniotic fluid aspiration & neonatal pneumonia can have an identical presentation in the newborn period.
ARDS... In adult respiratory distress syndrome, ards, there is a severe lung reaction from some inciting event like infection, trauma, pulmonary embolus, cardiac causes, etc. The lungs develop severe, bilateral interstitial changes and the patient usually requires mechanical ventilation while the underlying cause is diagnosed and treated.
Absolutely. There have been many studies showing excellent lung function in children who suffered from respiratory distress syndrome as premies. However, these babies may be more susceptible to long term consequences to the developing lungs of viral infections, cigarette smoke and allergens.