NEonatal presenations 2 Flashcards
3 DDxs for neonatal resp distress
- Transient tachypnoea of Newborn (TTN)
- Sepsis
- Meconium Ileus
What is ttn?
a delay in clearing foetal lung fluids
Looks like grunting, tachypnoea, O2 requirement but normal gasses
How can you test for and treat TTN?
CXR can spot the fluids & hyperinflation
O2, airway support, fluid and maybe Abx
What could lead to Meconium Aspiration?
Post-date
Maternal DM or HTN
Difficult Labour
How would meconium Aspiration present?
Cyanosis
High work of breathing + grunting
Apnoea
Floppiness
What would do if you suspect meconium aspiration?
Blood gas
CXR - hyperinflation, flat diaphragm & patchy areas of collapse
Also do a septic screen in case
Whats in a septic screen?
FBC
U&Es
Glc
Blood culture
CXR
LP
Urine dipstix & culture
How do you treat meconium aspiration?
Suction the meconium
Intubate & ventilate
IV fluids & Abx
Surfactant
NO or ECMO
Any complications of meconium aspiration?
Persistant Pulm HTN of Newborn (PPHN)
How can you treat neonatal hypoglycaemia?
Enteral Feeds
IV 10% glc
Fluids
Glucagon
Hydrocortisone
Birth Asphyxia is a serious problem in which low O2 at birth –> Multiorgan failure. What could cause it?
- Placental problems
- Cord Prolapse
- Infection
- Neonatal Airway abnormality
- Long, difficult delivery
What are the phases of birth asphyxia?
Stage 1 = cell damage occurring within minutes
Stage 2 = reperfusion injury due to toxins from damaged cells (Days or weeks)
How do you classify birth asphyxia?
Mild
Mod
Severe
How do you manage a baby with birth asphyxia?
Fluid restriction (prevent cerebral oedema)
Monitor U&Es + C & LFTs for organ failure
Resp support (O2, intubate, ventilate etc)
Cardiac support
Treat any seizures
Therapeutic Hypothermia!
Which babies get diaphragmatic hernias?
Male > Female
Ass with some syndromes
Mostly left
Also associated with pulm hypoplasia
