neonatal respiratory issues Flashcards
neonatal acute respiratory distress - ddx to consider (6)
airway
- foreign body
- trauma
respiratory tract
- pertussis
central
- infection
- metabolic acidosis
cardiac
- congenital heart disease
neonatal cough - ddx to consider (5)
airway
- tracheo-oesophageal fistula
- tracheo-bronchomalacia
respiratory
- resp infection
- chronic lung disease
cardiac
- congenital heart disease
neonates with noisy breathing - ddx to consider (5)
choanal atresia vocal cord paralysis laryngomalacia laryngeal or subglottic mass tracheomalacia
what is choanal atresia
when the back of the nasal passage is blocked so air can’t get through. congenital defect, bad for babies
neonates with apnoeic episodes - ddx to consider (6)
not acquired
- prematurity apnoea - if <37weeks
- periodic breathing
- structural airway obstruction
acquired / mystery
- BRUE - brief resolved unexplained event -> further review indicated
- infection
- head trauma
neonatal apnoea - definition
no respiratory effort for 20 seconds
no resp effort for 10 seconds + bradycardia or oxygen desaturation
neonatal apnoea - acute management (6 steps)
- observe event to work out whether its obstructive, central or mixed
- tactile stimulation - rub soles of feet, or chest
- reposition head into neutral position to maintain airway patency
- PEEP to maintain airway
- BLS pathway if no response
- Document event
pharmaceutical management of apnoea of prematurity
caffeine citrate as IV or PO
neonatal tracheomalacia, laryngomalacia - management
educate on natural history of presentation
- gets louder over 6 months, resolve by 12-18 months
does not require management if otherwise thriving
expected natural history of neonatal tracheomalacia and laryngomalacia
- loudness increases over 6 months
- resolution by 12-18 months
