Respiratory and Cardiac Conditions Flashcards
factors that impair fluid removal in the lungs
CAESAR SURFS END HY SEDATES
caesarian birth surfactant deficiency endothelial cell damage hypoalbuminemia sedation of the baby
t/f rds is 60-70% more common in <28 aog
false, 60-80%
main features of rds
surfactant deficiency -> increased alveolar surface tension -> ateletasis or atelectrauma and impaired frc
establishment and maintenance of ____ leads to optimal exchange of oxygen and carbon dioxide between alveoli and blood
functional residual capacity (expiratory reserve volume + residual volume)
mature levels of surfactant are present at ___
35 aog
sequelae of rds
atelectasis (perfused but not ventilated alveola) -> hypoxia, hypercapnia, acidosis, pulmonary arterial vasoconstriction, epithelial cell injury -> hyaline membrane formation
clinical manifestations of rds
rapid shallow breathing expiratory grunting chest retractions nasal flaring cyanosis
preventive management for rds
avoid cs for <39 aog
antenatal steroids before 37 aog (esp with premature)
how to establish frc for rds management
ncpap mechanical ventilation (for respiratory failure or persistent apnea)
what is apnea
prolonged cessation of breathing
- > 20 s
- <20 s + change in tone, pallor, cyanosis, bradycardia
surfactant replacement therapy in rds
INSURE = INtubate, administer SURfactant through et, Extubate
MIST / LISA = invasive
self limited tachypnea associated with delayed clearance of fetal lung fluid. early onset tachypnea in term infants.
transient tachypnea of the newborn
pathogenesis of ttn
ineffective expression or activity of enac and na-k atpase -> decreased pulmonary compliance and impeded gas exchange
clinical manifestations of ttn
respiratory distress with rapid recovery
no radiographic findings of rds
management for ttn
supportive care
inhaled b2 agonist albuterol
t/f meconium aspiration is most common in preterm neonates
false, post term after 42 aog
meconium aspirated in utero or with first breath can result to
small airway obstruction and respiratory distress = grunting and cyanosis
complete obstruction of airway = _______
partial obstruction = ____
complete obstruction = atelectasis and ventilation-perfusion mismatch
partial obstruction = half valve effect, air trapping, and air leaks
both = acidosis, hypoxemia, hypercapnia
xray for meconium aspiration
patchy infiltrates coarse streaking of both lung fields
increase in ap diameter
flattened diaphragm
management for meconium aspiration
preventive: identify and deliver
supportive: exogenous surfactant, inhaled NO, mechanical ventilation, extracorporeal oxygenation
pathogenesis of congenital pneumonia
aspiration or ingestion of bacterial in amniotic fluid (maternal chorioamnionitis)
clinical manifestations of congenital pneumonia
before delivery: fetal distress, tachy
during: failure to breathe, rd, shock
after: rd and shock
treatment for congenital pneumonia
ampicillin iv (g+) gentamicin (g-) ampicillin + cefotaxime (after discharge)
vessel transpositions in toga
aorta from rv
pulmonary artery from lv
