Neonatal Transition Pathophysiology

Question 1

What is the purpose of nasal flaring?

Answer 1

Compensatory endeavour to decrease nasal airway resistance

Question 2

Retractions

Answer 2

Occurs in neonates with increased chest wall compliance or decreases lung compliance
Increases the negative intrapleural pressure during inspiration
Demonstrates worsening lung compliance before resp failure can be detected by blood gas

Question 3

Grunting

Answer 3

Generates positive en expiratory pressures

Opens small airways and increases ventilated areas to improve the V/Q ratio

Question 4

Head bobbing

Answer 4

Using accessory muscles to breathe

Question 5

Transient tachypnea of the newborn

Answer 5

Most common cause of neonatal resp distress
Benign, self limiting, transient
Lasts < 48-72 hours
Due to delayed clearance of fetal lung fluid
Usually in the term/late pre-term newborn
Mold-moderate

Question 6

Neonatal respiratory distress syndrome

Answer 6

Lack of surfactant production/release in the alveoli
Progressive collapse of the terminal bronchiole/alveoli
Primarily a disease of preterm babies
Varying degrees of distress/O2 needs
Will get worse over time if not managed

Question 7

4 things to check in an intubated baby

Answer 7

ETT not kinked or displaced
Suctioned for loose white secretions
Already receiving 100% O2
All monitors are properly applied

Question 8

Pneumothorax

Answer 8

Air leak in the pleural space
Presents with an acute increase in resp distress and o2 requirements
Tension pneumo can present with sudden onset of CV collapse

Question 9

Meconium aspiration syndrome

Answer 9

Babies need to have a functionally mature GI tract
Born in the presence of meconium
Mechanical obstruction, chemical inflammation, surfactant inactivation
Severe MAS is life threatening

Question 10

Congenital diaphragmatic hernia

Answer 10

Bowel in the chest cavity
Mostly on the left side
Variable presentation
Lungs are hypoplastic