Preterm neonate with respiratory distress syndrome
Patient
6h · Male
Date
9 Oct 2026
Chief Complaint
Grunting and fast breathing shortly after birth for 6 hours
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Clinical Case
age
6 hours
sex
M
Grunting and fast breathing shortly after birth
Duration
6 hours
History of Present Illness
onset
Within 1 hour of birth
course
Worsening oxygen requirement
associated symptoms
- Grunting
- Subcostal recession
- Nasal flaring
medical
Born at 30 weeks by emergency C-section; mother received one dose of antenatal steroids
vitals
HR
162
RR
74
TEMP
36.4
SPO2
88% on CPAP FiO₂ 40%
weight
1.35 kg
general
Preterm, pink on CPAP, moderate respiratory distress
imaging
- Chest X-ray: ground-glass appearance with air bronchogramsHour 2
labs
- Blood gas: pH 7.24, PCO₂ 58Hour 3
primary diagnosis
Respiratory distress syndrome of prematurity
differentials
- Transient tachypnoea of the newborn
- Early-onset sepsis
medications
- Poractant alfa (surfactant)200 mg/kg via LISAHour 4
- Ampicillin + gentamicinPer NICU protocolHour 1
- Caffeine citrate20 mg/kg loadHour 4
procedures
- Nasal CPAP 6 cmH₂OBirth
follow up
Wean CPAP as tolerated; stop antibiotics at 48 h if cultures negative