Resp disease of neonates Flashcards
Signs of resp disease of neonates
RR> 60 Grunting nasal flaring subcostal recession cyanosis laboured breathing
care o2 levels arent always useful - are normally low around birth
Define resp disease of neonates
Set of disease that present early after birth (from 2 mins to a few days)
causes can vary
Transient tachypnea of the neonate
Persistant Pulmonary hypertensions
Chronic lung disease of prematurity
Respiratory distress syndrome
Transient tachypnea of newborn
Most common pulmonary issue in TERM babies
caused by delayed resorbtion of fluids by the lungs
Risk factors β C sections!
sx -the classical resp distress signs (1st card -RR>60, grunting, nasal flaring, subcostal recession, cyanosis,
Investigations and management of transient tachypnea of the newborn
Ix - RR>60, cyanosis (spo2 low)
CXR -fluid in horizontal fissure +/- hyperinflation of lungs
diagnosis of EXCLUSION
Mx -usually resolves on its own in 1-2 days
O2 supplementation if needed
Persistant pulmonary hypertension
Dangerous condition that can either be primary or secondary to other serious perinatal events :
Meconium aspiration, RDS, Birth asphixia, spesis
High pulmonary vasc resistance -> right to left shunting within lungs
Signs and Sx-
Cyanosis at/after birth
absent heart murmurs
Signs of Heart failure (R HF)
Prognosis Mortality under 10% but complications present in 25% of cases
Ix and Mx of persistant pulmonary hypertension
Ix
Urgent Echocardiogram to make sure its not heart
CXR -normal heart with oligaemia
Mx -cut between medication and supportive support-ventilation Mechanical CPAP/BiPaP High frequency ventilation and if extremely severe - ECMO
Medication-
Nitrous oxide
Sildanefil (viagra)
Chronic lung disease of prematurity
Not one disease/cause perse
Usually defined as needing o2 support past 36 weeks
CLD occurs following intrauterine infections, barotrauma (pressure) or iatrogenic trauma
RF- Happens in premature babies (very premmie), Low birth weight, low GA
Signs and Sx -
Signs of resp distress
Weight loss, poor feeding
classically progress in 23w to 26w go from VENTILATION to CPAP to Supplementary O2
Positive response to O2 and ventilation in first 2 weeks of life
Ix and Mx of Chronic lung disease of prematurity
CXR - widespread opacication
ABG/VBG -acidosis, hypercania, hypoxia
Mx - wean from full support to CPAP to more normal O2
always be worried by ventilation associated lung injury
Corticosteroids/dexamethasone -helps in short term -but concerned over long usage (neuro issues)
Respiratory distress syndrome
Cause by lack or issues in lung surfactant
COMMON in premmie babies <28 weeks
RF -premmie, Male, mother with t2dm, CS, 2nd born premmie twin
Signs and sx βAT DELIVERY OR UP to 4h after birth
RR>60, grunting, flaring, subcostal recession, cyanosis etc
Ix and Mx of Respiratory distress syndrome
Ix -clinical diagnosis
O2 sats low
CXR -GROUND GLASS APEARENCE, common pneumothorax, indistinct heart border
Mx -
ANTENATAL (if know baby going to be born before 34w)-steroids help lung developemnt
POSTNATAL -O2 and ventilation (CPAP or artificial), might need exogenous surfactant
mechanical ventilation