Neonates Flashcards
What are the 6 ways oxygenation be improved in neonatal ventilation?
- Increase FiO2
- Increase Mean Airway pressure by:
- increasing PEEP
- increasing PIP
- increasing Ti
- decreasing Te
- increasing flow
What are the 2 ways ventilation (CO2 removal) can be improved if underventilating/ high PaCO2?
- Increase amplitude
- Reduce frequency (Hz)
Swelling that does not cross suture line?
Cephalohaematoma
Caput, chignon and SGH all do
Cause of reverse sats differential (ie lower sats in R hand than lower limbs)?
TGA with PDA + coarctation or high PVR
What are the benefits of antenatal corticosteroids?
Reduced risk of perinatal and neonatal death, RDS, IVH, NEC, infection and childhood developmental delay
No effect on BW or CLD
What are the benefits of antenatal MgSO4?
Reduced risk of cerebral palsy and substantial gross motor dysfunction
Risk factors for RDS?
Prematurity (risk inverse to gestational age)
Male
Infant of diabetic motor
Perinatal asphyxia
2nd born preterm twin
Benefits of surfactant in RDS?
Reduces mortality, need for mechanical ventilation, BPD and air leak
Risk factors for NEC?
- Prematurity
- IUGR
- Enteral feeding
- Intestinal hypo perfusion from CHD, hypotension, significant PDA, perinatal asphyxia
Features of stage 1, 2 and 3 NEC?
Stage 1: temp instability, apnoeas and Bradys, mild distension, blood in stools (gross = 1B)
Stage 2: As above plus absent BS, tenderness (1B: cellulitis, mild metabolic acidosis, thrombocytopenia)
Stage 3: as above plus low BP, DIC, neutropenia, peritonitis. Requires surgery
Causes of late onset neonatal sepsis (>72hrs)
CoNS (lines), S aureus, E coli, enterobacter, klebsiella
What is ROP ‘plus’ disease?
Presence of dilatation and tortusosity of the posterior pole blood vessel involving at least 2 quadrants of the retina (associated with worse outcomes)
What is Bevacizumab (Avastin)?
Anti-VEGF monoclonal antibody used in ROP
