RESPIRATORY DISTRESS

Question 1

What are the cardinal signs of RD?

Answer 1

Tachypnoea (RR>90)
Recessions: sternal, rib, subcostal
Grunting
Central cyanosis

Question 2

What are the causes of respiratory distress?

Answer 2

Most common: Hyaline membrane disease, Wet lung syndrome, meconium aspiration syndrome, pneumonia
Other: Chronic lung disease, pneumothorax, lung hypoplasia, congenital abnormalities.

Question 3

What are the non- respiratory causes of RD?

Answer 3

Hypothermia, hypoglycaemia, congenital heart disease and metabolic acidosis.

Question 4

Who is at risk of HMD?

Answer 4

Preterm infants < 35 weeks
Infant of diabetic mothers

Question 5

What is the pathophysiology of HMD?

Answer 5

Surfactant is produced after 34 weeks

Question 6

What are the clinical signs of HMD?

Answer 6

Respiratory distress soon after delivery and worsens for 72 hrs then improves as surfactant is produced and resolves in 1 week.

Question 7

What are the CXR features of HMD?

Answer 7

Under-expanded lungs, Bilateral disease, extend from the lung to peripheries. Presence of air-brochograms.

Question 8

How is HMD managed?

Answer 8

Administer steroids (Betamethasone) to mom if expected to deliver before 34 weeks.
Respiratory support to relieve hypoxia.
Surfactant replacement therapy (LISA method preferred)
Transfer to ICU
Monitor Sats
Temperature control
Antibiotics of infection is suspected

Question 9

Which fetuses are at risk of Meconium Aspiration?

Answer 9

Term or post term stressed in UTERO.