RDS or Hyaline membrane Disease – Classic X ray

A Preterm 33+ weeks male with Perinatal asphyxia presented with Rerpiratory distress at 16 Hour of life. The baby was in respiratory failure so was Intubated immediately and put under mechanical ventilation. The baby required high PIP as lungs were stiff.

Xray was ordered with showed-

Bilateral White out lung field with Air Brochogram.

In Such cases of RDS of Prematurity, best management would have been-
1, Dexamethasone or Betamethasone therapy intrauterine atleast 24 hrs before delivery to provide maturation of lungs.
2. Early CPAP to prevent collapsing of alveoli after delivery if any signs of Distress
3. If feasible , Surfactant therapy within 6 hours with FiO2 requirement increases.

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