Respiratory Distress & SIDS PDF

# Respiratory Distress Syndrome - The most common respiratory disorder in premature infants is hyaline membrane disease or infant respiratory distress syndrome (RDS). - It is caused by a deficient amount of pulmonary surfactant. - Because surfactant decreases surface tension, the alveoli involved i...

# Respiratory Distress Syndrome - The most common respiratory disorder in premature infants is hyaline membrane disease or infant respiratory distress syndrome (RDS). - It is caused by a deficient amount of pulmonary surfactant. - Because surfactant decreases surface tension, the alveoli involved in RDS have increased surface tension and collapse. - Underdeveloped alveoli and pulmonary capillary beds further compromise gas exchange. - Respiratory distress syndrome is characterized by airless alveoli, inelastic lungs, a respiration rate greater than 60 breaths per minute, nasal flaring, intercostal and subcostal retractions, grunting on expiration, and peripheral edema. - The incidence of RDS increases with decreasing gestational age. - Continuous positive airway pressure will aid in preventing alveolar collapse. ## A Study of 126 Children - A cross-sectional study of 126 children with a mean age of 10 years whose mean gestational ages at birth were 27 weeks was published in 2008. - The children in the study had birth weights of less than 1000 g, and they were born 1992 through 1994. - The study compared term-born children with the group of children described earlier. - They examined the lung function of each group using spirometry and fitness level, which they determined by using the 6-minute walk test and the 20-m shuttle run test. - The data demonstrated no difference between the two groups in the distance walked on the 6-minute walk test. - The two groups did, however, demonstrate significant difference in spirometry. - The preterm group showed exercise capacity of approximately half that of the control group. - The authors concluded that although exercise capacity was reduced, it is unknown if training can change that finding. - This study is an excellent example of using information that exists about the children we treat to motivate us to learn more. # Sudden Infant Death Syndrome - Sudden infant death syndrome (SIDS) is the sudden, unexpected death during sleep of an otherwise healthy infant. - Sudden infant death syndrome may be linked with respiration; the mechanism, however, is still largely unknown. - The "Back to Sleep" campaign was launched by National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health in 1994 in order to decrease the incidence of SIDS. - The campaign initially promoted infants sleeping on their backs or sides. - The campaign later revised its message to encourage putting infants to sleep only in the supine position. - Sudden infant death syndrome incidence has declined by greater than 50% since launching the "Back to Sleep" campaign. - Physical therapists should be aware of the "Back to Sleep" campaign and the American Academy of Pediatrics recommendations in regard to sleeping position. - Given that, physical therapists should also be aware of the importance of educating families about intermittent periods of prone play while the baby is awake and under direct observation. - The pediatric physical therapist plays a key role in encouraging compliance with sleeping recommendations in the supine position for safety, as well as encouraging supervised prone activities when the baby is awake, for optimal development.