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Respiratory distress in newborn - PowerPoint

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					Respiratory distress in newborn
4th year seminar

RDS
• • • • Most common respiratory illness in NICU Occur in premature neonate Surfactant deficiency Risk factors
– Asphyxia and stress – Male – Acidosis – DM mother

signs
• • • • • • • tachypnea retraction grunting Nasal flaring apneic episode cyanosis extremities puffy or swollen

Chest X-ray
• Ground glass appearance • Reticulogranular • With air bronchograms

Physiologic abnormalities
• • • • • Lung compliance 10-20% of norm Atelectasis…areas not ventilated Areas not perfused Decrease alveolar ventilation Reduce lung volume

surfactant
• Type 2 pneumocytes lamillar body 22weeks…34-36wks • Phosphatidylcholine • Surfactant specific protein • Recycling and regeneration (including externally given surfactant)

surfactant
• • • • • Decrease surface tension at air liquid level Equalize tension in alveoli of different size Increase in lung compliance. Absence of surfactant cause RDS Pulmonary hypertension

Treatment
• Surfactant Fujiwara…1990s
– Prevention – rescue

• Supportive
– Thermal – Fluid and nutrition – oxygen

• Mechanical ventilation

Acid base In RDS
• • • • • pH PaCO2 PaO2 HCO3 Base deficit

complications
• • • • • Pneumothorax PDA Chronic lung disease Sepsis Line problems

Meconium aspiration
• First stool that constitutes the GI epithilium and secretion during fetal life • Stress and intra-uterine meconium in term infant • Gasping cause the aspiration • Chemical diffuse peumonitis • Same signes of distrss and PPHN. • Treatment maily supprtive

Congenital pneumonia
• Sepsis risk factors
– PROM – Preamturity – Maternal fever, dicharge, abdominal pain, leukocytosis – Colonization with GBS

• Same signs of RDS • X-ray

Transient tachypnia of newborn
• • • • • • Term Cesarian delivery Usually tachypnia without O2 requirment Resolve in 48-72 houres Lung fluid X-ray


				
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