Resp disorders Flashcards
Transesophogeal Fistula
dx
quick diagnosis—NG into blind pouch
bronch is diagnosis of choice
H type TEF
TEF without esophogeal atresia
3-4 months of age, cyanosis with feeding, resp distress and pneumonia
GERD causes biggest cause of recurrent resp distress
Maternal usually has polyhydrominos
Preop TEF
low pressure ventilation
no pacificer
prone with HOB 30
Croup
Diffuse inflammation of subglottic tissue
results in upper airway inflammation and narrowing
most common age group 3-36 months
Causes of croup
para influenza*, RSV, Adenovirus
S/S Of Croup
Low grade temp, Barking cough, URI symptoms, inspiratory stridor, retraction
Chest xray of croup shows
Steeple sign (inverted V)
Tx of croup
Neb rac epi
systemic or neb corticosteroids
intubation
avoid agitation
heliox in extreme cases (lower density and less turbulent)
With croup–when complete obstruction imminent will see
normal gas exchange with low o2
Epiglotitis
Swelling of epigolitis and surrounding structure–causes obstruction
most common between 2-6 years old but can occur at any age
Causes of epiglotitis
bacterial infection–ie influenza
caustic ingestiton, thermal injury, trauma
S/S of epglotitis
sudden onset of high fever dysphagia, drooling, resp distress tripod positioning muffle voiced hyperextension of neck
pulm edema can occur from increased pressure gradient causing aviolar hypoxia
chest xray of epiglotits will show
thumb sign on LATERAL not AP
late sign of epiglotitis
stridor
tx of epilotitis
antibiotics, DO NOT AGITATE, blow by o2, intubate in OR
rac epi if needed
RDS
associated with prematurity and decreases surfacant
associated with increases reistance, decreased compliance, decreased FRC, V/Q mismatch and hypoxemia
S/S of RDS
Tachypnea, grunting, flairing, retractions, tachycardia, cyanosis, murmmur, crackles, peripheral edema
Chest xray of RDS
ground glass appearnce
Tx of RDS
02 therapy, caffeine (less than28 weeks) surfactant therapy,
BPD s/s
hypoxia and hypercapnia resp distress failure to wean vent acidosis and fluid intolerance rhales, rhonchi, wheezing FTT Heart failure
Chest xray of BPD
scattered infilitrates, atelectasis, patchy area of hyperinflation, increased intersitial markings, cardiomegaly (swiss cheese appearance)
TX Of BPD
Avoid High PIP Po2 of 55 Pco2 45-60 bronchodialators CPT Nutrition
POst op TEF complications
anamositis site leakage—s/s temp instabliity, frothy (purluent) chest tube drainage, increased WBCs
