9.7 Respiratory Distress Syndrome Flashcards
What is ARDS?
Damage to the airsacs of the lung leading to the formation of hyaline membranes
What are the problems in ARDS?
- Thickening of the membranes leads to the development of cyanosis and hypoxemia
- Collapse of the lung
What are the CXR findings of ARDS?
Diffuse white out
What is the main mechanism of ARDS?
Activation of neutrophils induces protease mediated free radical damage of type I AND type II pneumocytes
What is a complication of ARDS recovery?
Interstitial fibrosis due to damage to the type II pneumocytes
What is the cause of NRDS?
Respiratory distress in neonates due to inadequate surfactant levels
What are the clinical features of NRDS?
Increasing respiratory effort with use of the accessory muscles with hypoxemia and cyanoisis
What is seen on CXR of NRDS?
Diffuse granularity of lung on x-ray
What are the key causes of NRDS?
- Premature birth
- C-section
- Maternal diabetes
How can NRDS be screened for?
Lecithin to Sphingomyelin ratio - increased L:S ratio greater than 2 indicates maturity of lung
What is the main component of surfactant?
Lecitihin (phosphatidylcholine)
Why does C-section cause increased risk of NRDS?
There will be no release of steroids since there is no stress with birth which will lead to a decreased production of surfactant
Why does maternal diabetes increase risk of NRDS?
Insulin inhibits surfactant synthesis
What are the complications of NRDS?
- Persistence of PDA due to hypoxemia
- Necrotizing enterocolitis
- Free radical injury with supplemental O2 can damage retina and lung - bronchopulmonary dysplasia
