What initial investigations should be performed to confirm a diagnosis of RDS in a neonate?

The provided UK guidelines do not explicitly detail specific initial investigations solely for confirming a diagnosis of respiratory distress syndrome (RDS) in a neonate. However, initial assessments for respiratory distress in neonates and young children, which would inform a diagnosis, include a thorough clinical assessment and measurement of vital signs ²,³.

• Clinical Assessment: Healthcare professionals should observe for signs such as grunting, marked chest recession, cyanosis (bluish lips or extremities), agitation, and exhaustion ³. Hydration status should also be assessed by measuring capillary refill time, examining skin turgor and dryness of mucous membranes, and ascertaining urine output ³.
• Vital Signs Measurement: This involves recording the child's respiratory rate, pulse, and blood pressure ³. The child's temperature should also be measured ³.
• Oxygen Saturation: Oxygen saturation levels should be measured in room air using pulse oximetry, if available ²,³.

It is important to note that factors such as being born prematurely, particularly before 32 gestational weeks, should lower the threshold for hospital admission due to respiratory concerns ³. Furthermore, interventions like treatment with surfactant and invasive ventilation begun within 24 hours of birth are identified as risk factors for bronchopulmonary dysplasia (BPD), reflecting the severity of the baby's initial respiratory condition, which can include RDS ¹.