Improving RDS treatment with current drugs

Abstract

Currently attributed to a lack of foetal lung development, respiratory distress syndrome is the eighth largest cause of infant mortality (USA). Corticosteroids have proved successful but are not infallible in this indication having both a 24-hour latency and little effect on surfactant production. In vivo evidence shows a triggering event in vaginal delivery leads to a rapid final preparation of the lungs, accelerating fluid re-adsorption and surfactant production. It may be possible to reproduce accelerated adaptation synergistically with natural and steroidal maturation; however this would require looking again at β-agonists. Vulnerable pregnancies may be better served by corticosteroids, oxytocin tocolytics. A single dose of a β-agonist immediately before delivery may maximise adaptation while avoiding previous failings of this therapy. Trends in premature birth and caesarean section, make prevention of this syndrome increasingly challenging, however room for improvement may be possible with current therapies.

Keywords::

• β-agonist
• caesarean
• oxytocin
• respiratory distress syndrome
• surfactant

Declaration of Interest: The authors report no conflict of interest.