Hyaline membrane disease - Complications of neonatal respiratory distress syndrome

There is a significant risk that babies who experience neonatal respiratory distress syndrome (NRDS) will develop further problems.

Air leaks

In some cases of NRDS, air can leak out of the lungs and become trapped in the chest cavity. This is known as pneumothorax.

The pocket of air places extra pressure on the lungs causing them to collapse and leading to additional breathing problems.

Air leaks can be treated by inserting a tube into the chest to allow the trapped air to drain.

Internal bleeding

Babies with NRDS may experience bleeding inside their lungs (pulmonary haemorrhage) and brain (cerebral haemorrhage).

Bleeding into the lungs can be difficult to treat but usually air pressure from a ventilator and transfusion of blood products allows the bleeding to stop.

Bleeding into the brain is quite common in premature babies, but fortunately most bleeds are mild and there are few longer term problems. Larger bleeds occasionally require surgery to drain accumulating fluid.

Bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is a long-term lung condition that can affect some children with NRDS. It develops when the ventilator used to treat NRDS causes scarring to the lungs that affects their development.

Symptoms of BPD include, rapid, shallow breathing and shortness of breath.

Babies with severe BPD usually require additional oxygen, through tubes into their nose, to help with their breathing. This is usually stopped after a few months when the lungs have healed.

However, children with BPD may require regular medication, such as bronchodilators, to help widen the airways of their lungs and assist with their breathing.

Developmental disabilities

If the brain is damaged during NRDS, either due to bleeding or a lack of oxygen, it can lead to long-term developmental disabilities such as learning difficulties, movement problems, impaired hearing and impaired vision.

However, these developmental problems are not usually severe. For example, one survey estimated that three out of four children with developmental problems only have a mild disability that should not stop them leading a normal adult life.