The symptoms and signs of respiratory distress syndrome vary and include lengths of the nostrils, intercostal, subcostal and suprasternale recoveries, weak breathing, irregular breathing, or both; Further, tachypnea and apnea attacks, cyanosis, pallor, spotty skin, delayed capillary refill, and hypotension or both. In newborns, the symptoms and signs develop immediately after birth or minutes or hours. Etiology respiratory distress syndrome in newborns and infants have many causes (see Table: Causes of respiratory distress syndrome in newborns and infants). Causes of respiratory distress syndrome in newborns and infants category causes cardiological right-left shunt with normal or increased pulmonary flow: transposition of the great vessels, total anomalous venous return, truncus arteriosus, hypoplastic left heart syndrome right-left shunt with reduced pulmonary flow: pulmonary atresia, tetralogy tetralogy, critical pulmonary stenosis, tricuspid atresia, single ventricle with pulmonary stenosis, Ebstein’s anomaly, persistent fetal circulation or persistent pulmonary hypertension Respiratory top he tract: choanal stenosis or stenosis, tracheobroncholaryngealeStenose, pressure barrier (eg. As vascular ring), tracheoesophageal anomalies (e.g., column, fistula) Lower tract. Respiratory distress syndrome, transient tachypnea of ??the newborn, meconium aspiration, pneumonia, sepsis, pneumothorax, diaphragmatic hernia, pulmonary hypoplasia, cystic malformation of the lung, congenital lack of surfactant proteins B or C neurological intracranial haemorrhage or hypertension, oversedation (the baby or the mother), diaphragmatic paralysis, neuromuscular disorders, convulsive disorders Hämatologisch methemoglobinemia, polycythemia, severe anemia Other hypoglycemia, blood loss, metabolic disorders (eg., acid-Bas en disorders, hyperammonemia), hypovolemic shock physiology There are significant differences in respiratory physiology of newborns, infants and older children and adults. These differences are A lighter collapse of the chest wall A major function of the diaphragm as, extrathoracic from the intercostal muscles collapsible airways infants also have lower airway diameter having a higher resistance and a tendency to atelectasis. However, the respiratory physiology is similar in children and adults. Clarification The assessment begins with a careful history and clinical examination. The history in newborns focuses on maternal and prenatal history, especially gestational age, maternal infections or bleeding, mekoniumhaltiges amniotic fluid, oligohydramnios and polyhydramnios. In clinical studies, the heart and lungs in focus. Thorax asymmetries or a sunken abdomen indicate a diaphragmatic hernia (diaphragmatic hernia). Asymmetric breath sounds suggest pneumothorax (Pulmonary Air leak syndrome: pneumothorax), pneumonia (pneumonia in newborns) or asthma way. A displaced apex beat and / or a heart murmur suggest a congenital heart defect (congenital heart defects at a glance). An evaluation of blood pressure and the femoral pulses can identify a circulatory collapse with or without congenital defects. A poor capillary refill indicates circulatory disorders. In neonates and infants, it is important to measure the oxygen saturation and response to O2 transfer with pulse oximetry. Chest X-ray is recommended.