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TAS Neonatal Medicine ✅ > Respiratory Distress ✅ > Flashcards

Respiratory Distress ✅ Flashcards

1
Q

Why do extremely premature infants have problems with their lungs?

A

They are born at an early stage of lung development, before the development of alveoli and have deficient surfactant production for extrauterine life

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2
Q

What categories of factors influence fetal lung growth and maturation?

A
  • Physical
  • Hormonal
  • Local
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3
Q

What physical factors influence fetal lung growth and maturation?

A
  • Fetal respiration

- Fetal lung fluid

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4
Q

What hormonal factors influence fetal lung growth and maturation?

A
  • Glucocorticoids
  • Prolactin
  • Insulin
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5
Q

What local factors influence fetal lung growth and maturation?

A
  • cAMP

- Methylxanthines

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6
Q

What is the function of airways?

A

To conduct airflow

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7
Q

Do upper airways take part in gas exchange?

A

No

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8
Q

What maintains upper airway patency?

A

Stable pressure balance between collapsing forces and dilator forces of supporting musculature

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9
Q

Which airways take part in respiratory gas exchange?

A

Portions of the conducting airways of intrathoracic trachea (lower airway)

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10
Q

Which portions of the lower airway take part in respiratory gas exchange?

A

Terminal and respiratory bronchioles and alveolar ducts

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11
Q

What can cause narrowing of the airways?

A
  • Inflammation
  • Excessive secretions
  • Reactive airways
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12
Q

What can narrowing of the airways lead to?

A

Increased resistance to airflow

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13
Q

What can increased resistance to airflow caused by narrowing of airways result in?

A

Increased work of breathing

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14
Q

Which thoracic and respiratory muscles are involved in respiratory function?

A
  • Diaphragm
  • Intercostal and accessory muscles
  • Abdominal muscles
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15
Q

What are the clinical features of respiratory distress in a newborn?

A
  • Tachypnoea (respiratory rate >60/min)
  • Nasal flaring
  • Grunting
  • Chest recession
  • Variable cyanosis
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16
Q

What are the common causes of respiratory distress in a neonate?

A
  • Transient tachypnoea of the newborn

- RDS (in preterm infants)

17
Q

What are the less common causes of respiratory distress in a neonate?

A
  • Pneumonia/sepsis
  • Meconium aspiration
  • Pneumothorax
  • Congenital heart disease/heart failure
  • Persistent pulmonary hypertension of the newborn
  • Hypoxic-ischaemic encephalopathy
18
Q

What are the rare causes of respiratory distress in a neonate?

A
  • Surfactant deficiency (in term infants)
  • Congenital diaphragmatic hernia
  • Tracheo-oesophageal fistula
  • Pulmonary hypoplasia
  • Pleural effusion
  • Milk aspiration
  • Airway obstruction
  • Lung abnormalities
  • Neuromuscular disordrs
  • Metabolic acidosis
19
Q

Give an example of a cause of airway obstruction in a neonate

A

Choanal atresia

20
Q

Give 3 examples of lung abnormalities that can cause respiratory distress in a neonate

A
  • Congenital pulmonary airway malformation
  • Lobar emphysema
  • Pulmonary sequestration
21
Q

What can cause metabolic acidosis in neonates?

A

Inborn errors in metabolism

22
Q

When is transient tachypnoea of the newborn more common?

A

Following C-section

23
Q

What is clearance of fetal lung fluid largely dependent on?

A

Reabsorption of alveolar fluid via sodium channels in the lung epithelium

24
Q

What influences the reabsorption of alveolar fluid in the clearance of lung fluid?

A

Levels of circulating catecholamines

25
Q

How to levels of circulating catecholamines after C-section compare to after vaginal delivery?

A

They are lower after C-section

26
Q

What is the result of the lower levels of circulating catecholamines after C-section delivery?

A

Reduced absorption of lung liquid

27
Q

What allows the baby to fill the lungs with air at birth>?

A

The baby generates marked negative pressures

28
Q

What pressure is generated by the baby at birth to fill the lungs with air?

A

-60cm H2O

29
Q

What happens to the lung fluid with the first two or three breaths a baby takes?

A

Much of the fetal lung fluid is expelled

30
Q

What enhances the expulsion of lung fluid?

A

Generation of PEEP

31
Q

What generates the PEEP that helps expel lung fluid?

A

The baby crying against partially closed vocal cords

32
Q

What happens to the lung fluid that is not expelled in the first 2-3 breaths?

A

It is absorbed into the pulmonary lymphatics and capillaries over the first 6-12 hours

33
Q

What can delay in the absorption of lung fluid result in?

A

Respiratory distress

TAS Neonatal Medicine ✅ (35 decks)

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