Diagnosis of RDS can be confirmed biochemically by detecting surfactant deficiency, but in practice, it is most often based on clinical symptoms and characteristic findings on chest radiography. Typical radiographic features include:
Infants with RDS require specialized care in the neonatal intensive care unit (NICU) immediately after birth. Treatment focuses on providing respiratory support and replacing the surfactant.
Since the 1980s, exogenous surfactant replacement therapy has become the most effective treatment for RDS. Surfactant derived from bovine or porcine lungs is administered directly into the infant’s airway. The surfactant can be administered through an endotracheal tube while the infant is on mechanical ventilation. Alternatively, less invasive approaches can be used, such as Minimally Invasive Surfactant Therapy (MIST) or Less-Invasive Surfactant Administration (LISA), during noninvasive ventilation.
To maintain airway and alveolar expansion, infants may require invasive and noninvasive positive-pressure ventilation methods. The most common approach is invasive mechanical ventilation after endotracheal intubation. Depending on the severity of respiratory distress, noninvasive options such as nasal Continuous Positive Airway Pressure (nCPAP) or Noninvasive Positive-Pressure Ventilation (NIPPV) may also be applied.