Respiratory

Question 1

Why is the neonatal population at increased risk for unplanned extubations and what are potential consequences of UEs?

(December 2021)

Answer 1

Skin immaturity and humidified environment increases difficulty of securing ETT, narrower range of acceptable ETT depth, and sedation/analgesia meds limited because of safety and neurodevelopment concerns. Most likely consequences include increased time on the ventilator, increased pressure, increased FiO2 requirements, and increase in risk of BPD

Question 2

What features make a BRUE low-risk and what are the 4 criteria required for BRUE diagnosis?

(April 2022)

Answer 2

BRUE must include a) cyanosis/pallor b) absent/decreased/irregular breathing pattern c) abrupt change in tone and d) altered level of responsiveness

Low risk BRUE:
-age>/= 60d
-GA >/= 32 weeks and PCA at least 45 weeks
-occurrence of 1 BRUE
-duration < 1 minute
-no CPR required
-no concerning historical or physical exam findings