Neonate CxR stuff

Question 1

Adequate inspiration for CxR?

Answer 1

Adequate lung expansion is about eight ribs

• 9 ribs can suggest hyperinflation

Question 2

Overpenetration vs underpentration?

Answer 2

Over = dark film

under = white film

Question 3

What does the following indicate?

Answer 3

Soft tissue edema

• may require high vent pressures to overcome the weight of the chest + abdomen
• Pressures up to 30cmH2O or more may be needed

Question 4

What does the following indicate?

Answer 4

Increase in vascularity

• fluid in the fissure with hilar streaking of the chest field

Question 5

Normal heart findings?

Answer 5

• Cardiac to thoracic ratio size <60%
• 2/3 is on the left of the spine
• boarders?

Question 6

What factors can make the heart appear larger on a CxR?

Answer 6

Poor inspiration

• cardiac enlargment is not uncommon during the first 24hrs

Question 7

Under normal circumstances, can you see air in the stomach immediately after birth?

Answer 7

Yes. if not consider the following:

• Can babe pass stool?
• GI obstruction?
• Polyhydramnios, large gastric aspirates, abdominal distension, emesis,
• Guts are normally invisible on CxR but can be visible in the first 3hrs as they fill with air

Question 8

What level should the diaphragm sit for a neonate?

Answer 8

T9 during inspiration, can be elevated in cases of obstruction with distension or free air in abdomen