Hyaline Membrane Disease Flashcards
APGAR Criteria for newborn eval
newborn baby has HR 80, slow/irregular respirations, grimaces when getting tube up its nose, shows some muscle flexion, and has slightly blue tinged feet. WDYD?
APGAR Score = 5 Mod depressed
O2 ASAP, monitor for immediate resuscitation
pulmonary surfactant deficiency in lungs of neonates that causes respiratory distress syndrome
Hyaline Membrane Disease
most commonly babies <37wks
Why are babies with hyaline membrane disease hypoxic?
they dont have enough surfactant, which decreases the surface tension of the alveoli and makes them compliant under pressure (ventilation). Lack of oxygenation results in collapses alveoli and/or build up of thick mucus due to inhibited membrane transport
what & work up
within hours of birth, baby shows rapid, labored, grunting expressions, sternal retractions, and nasal flaring.
Hyaline Membrane Disease
- ABG, CXR
Hyaline Membrane Disease - ABG & CXR findings?
ABG - hypoxemia (low O2), hypercapnia (high CO2)
CXR - diffuse atelectasis, air bronchograms
Hyaline Membrane Disease
3 Prenatal Screens we can do if we suspect baby is going to be born <39wks
Amniocentesis to eval:
Lecithin/Sphingomyelin ratio
Foam stability index,
Surfactant/albumin ratio
risk of RDS is low when lecithin/sphingomyelin ratio is >2, phosphatidyl glycerol is present, foam stability index - 47, or surfactant/albumin ratio is >55mg/g
Hyaline Membrane Disease Trmnt for newborn
intratracheal surfactant
supplemental O2
Mechanical ventilation
all as needed or if indicated
newer research shows its more beneficial to intub and give surfactant rather than go straight to invasive CPAP (even for premies)
Hyaline Membrane Disease
What can we give to mom to hopefully prevent this if she delivers before 34 weeks?
Injectible steroids!
- 2 doses Betamethasone 12mg IM 24hrs apart OR
- 4 doses Dexamethasone 6mg IV or IM q12hrs ≥ 48 hrs prior to deliver. this will stim surfactant production
