[citation needed] The European Consensus Guidelines on the Management of Respiratory Distress Syndrome highlight new possibilities for early detection, and therefore treatment of IRDS.

[8] The guidelines mention an easy to use rapid point-of-care predictive test that is now available[9] and how lung ultrasound, with appropriate training, expertise and equipment, may offer an alternative way of diagnosing IRDS early.

[citation needed] As the disease progresses, the baby may develop ventilatory failure (rising carbon dioxide concentrations in the blood) and prolonged cessations of breathing ("apnea").

Despite huge advances in care, IRDS remains the most common single cause of death in the first month of life in the developed world.

[citation needed] The lungs of infants with respiratory distress syndrome are developmentally deficient in a material called surfactant, which helps prevent the collapse of the terminal air spaces (the future site of alveolar development) throughout the normal cycle of inhalation and exhalation.

[citation needed] Microscopically, a pulmonary surfactant-deficient lung is characterized by collapsed air spaces alternating with hyperexpanded areas, vascular congestion, and, in time, hyaline membranes.

Hyaline membranes are composed of fibrin, cellular debris, red blood cells, rare neutrophils and macrophages.

Structural immaturity, as manifested by a decreased number of gas exchange units and thicker walls, also contributes to the disease process.

[citation needed] The diagnosis is made by the clinical picture and the chest X-ray, which demonstrates decreased lung volumes (bell-shaped chest), absence of the thymus (after about six hours), a small (0.5–1 mm), discrete, uniform infiltrate (sometimes described as a "ground glass" appearance or "diffuse airspace and interstitial opacities") that involves all lobes of the lung and air-bronchograms (i.e. the infiltrate will outline the larger airways passages, which remain air-filled).

With the introduction of surfactant treatment for IRDS, Henrik Verder developed additional lung maturity tests based on gastric aspirates (GAS); for example, the microbubble stability test[18] and lamellar body counts (LBC)[19] as well as a large randomised trial using lamellar body counts to guide surfactant treatment.

Professor Henrik Verder, in collaboration with chemometric scientist Agnar Hoskuldsson, developed a rapid point-of-care method for predicting IRDS by measuring the lecithin-sphingomyelin ratio (L/S) in gastric aspirate (GA).

[9] The new method, which is based on mid‐red Fourier Transform Infrared spectroscopy (FTIR),[21] was shown to measure the L/S ratio at birth with a high sensitivity.

[23] Since then, several studies have supported the use of lung ultrasound scores to earlier predict an initial dose of surfactant when compared to current oxygenation-guided recommendations.

[30] The INSURE method has been shown, through meta-analysis, to successfully decrease the use of mechanical ventilation and lower the incidence of bronchopulmonary dysplasia (BPD).

[34] Based on the INSURE method, Henrik Verder has since developed a rapid bedside test that predicts IRDS at birth.

Furthermore, in infants aged less than 34 weeks of gestation, several physiologic systems are not well-developed, especially the cerebral vasculature and germinal matrix, resulting in high sensitivity to slight changes in pH, PaO2 and intracranial pressure.

Subsequently, preterm infants are at unacceptably high risk for intraventricular hemorrhage (IVH) if administered ECMO at a gestational age of less than 32 weeks.

[37] In pregnancies of longer than 30 weeks, the fetal lung maturity may be tested by sampling the amount of surfactant in the amniotic fluid by amniocentesis, wherein a needle is inserted through the mother's abdomen and uterus.

[38] Despite only 1% of all birth complications being attributed to respiratory distress syndrome, there is a significantly higher prevalence in prematurely born babies.

[40] Seventy percent of babies diagnosed with respiratory distress syndrome are born between 29 and 34 weeks of gestational age and are 55% more likely to be male.