Respiratory distress Flashcards
What is the definition of respiratory distress?
Common and important complication in newborn infants >2 or more of the following signs -tachypnea -expiratory grunting -nasal flaring -central cyanosis on room air -subcostal and intercostal recession
What are the predisposing factors that make a baby more likely to develop respiratory distress?
- Preterm delivery
- Csection
- Infant of diabetic mother
- Underweight for gestational age
- Complicated labour
- failure to breathe well at birth
What are the respiratory causes or conditions that cause respiratory distress?
- Transient tachypnea of the lung
- Meconium aspirations
- Pneumonia
- Bronchopulmonary dysplasia
- Persistent Pulmonary hypertension of the newborn
- Hyaline membrane disease
- Congenital diaphragmatic hernia
What are the non respiratory causes that cause respiratory distress?
- Hypothermia
- Metabolic acidosis
- Patent ductus arterioisus
- Congenital heart disease
What is hyaline membrane disease?
It is the most important cause of respiratory distress in infants
-it is due to the deficiency of surfactant in the lungs which causes the alveolar to collapse and increased effort for the baby to breath
How does surfactant work in the alveoli?
It causes decreased surface tension and allows respiration with minimal physical effort
What are the clinical signs of a baby with hyaline membrane disease?
- On chest X-ray there will be reticule-granular appearance and air bronchograms
- Baby will lay flat in the frog position
- Baby might experience cessation of breathing
What can we do to prevent hyaline membrane disease?
We can try to avoid elective c-sections
We can give the mom antenatal steroids to allow for lung maturity
We can also give betamethasone intramuscularly
What is the management for membrane hyaline disease?
- Prevent progressive alveolar collapse by
- oxygen saturation between 88-92%
- keep body temperature normal
- keep blood glucose normal
- provide adequate nutrition
- surfactant replacement therapy
What sort of oxygen therapy will a baby with HMD need?
- CPAP with nasal cannula
2. if not available give oxygen with nasals prongs
What are the early complications associated with HMD?
- pneumothorax
- intraventricular haemorrhage
- heart failure due to persistent pulmonary hypertension
What are the late complications of HMD?
-bronchopulmonary dysplasia
What is wet lung syndrome/transient tachypnea of the newborn?
- usually occurs to term newborn babies
- it is a respiratory problem that occurs soon after mostly elective c-sections
- period of tachypnea due to fluid remaining in the lungs
How long can we expect TTN to be present for?
Babies improve within 12-24 hours but tachypnea may be present for 7 days
What is the management of TTN?
-give nasal CPAP