The therapeutic challenges of respiratory distress syndrome in the newborn – case report
A. Nistor, R.M. Sima, L. Pleș, A.D. Stănescu
Rezumat: Severe respiratory insufficiency is commonly observed in
newborns with severe perinatal asphyxia. It represents
the result of underlying or subsequent disorders such as
meconium aspiration syndrome, sepsis or pneumonia.
Case report. We present the case of a newborn resulted
from a pregnancy without prenatal care. The pregnant
woman was admitted in advanced labor and she delivered
vaginally, 10 minutes later after the hospitalization. The
initial clinical examination of the newborn revealed a male
of 3780 g, IA 1/3/5, with severe asphyxia, who required
extensive resuscitation at birth in the delivery room. The
evolution was towards the deterioration of the general
condition during the first days of life, with hepatic and renal
insufficiency and metabolic disorders (hypoglycemia, hypocalcemia). The cardiac ultrasound did not detect changes
in parietal kinetics, valvulopathies or other flow-pressure
disorders capable of determining those clinical
symptoms. The neurologic examination revealed clonic movements of
the upper and lower limbs, decreased muscular tonus and
reflexes in the first days of life, but later
the tonus gradually improved. The transfontanelar ultrasound
showed the “flu” aspect of the brain substance, filiform
lateral ventricles located symmetrically to the midline and low Doppler flow. The evolution was favourable with intensive care treatment and the baby was discharged after 21 days. The
infant had a good general condition, with no fever and
with normal cardiac, respiratory, renal and hepatic functions.
Conclusions. Respiratory distress syndrome (RDS)
represents a challenge for neonatologists because it may
have different causes that determine the treatment and
follow-up of the newborn. When RDS is associated with multiple organs injuries, prolonged neonatal intensive care is required. Cuvinte cheie: perinatal asphyxia, respiratory distress
syndrome, neonatal sepsis, multiple organ failure.