Respiratory Distress in the Newborn Flashcards
What causes transient respiratory distress?
Post-asphyxia
Hypo/hyperthermia
What causes respiratory distress in term babies?
Sepsis Pneumonia Wet lung - most common Meconium aspiration (HMD unlikely) Congential - cardiac and space-occupying
What is wet lung/transient tachypnoea of the newborn?
Continued production or delayed removal of fetal lung liquid
What is the natural history of wet lung?
Gradual improvement over hours to days
What is the pathophysiology of meconium aspiration?
Blocked airways - Complete - distal collapse - Incomplete air leaks Chemical pneumonitis Potential infection
How do you diagnose a pneumothorax?
Chest asymmetry
Decreased air entry
Transillumination
CXR
What is a complication of congenital diaphragmatic hernia?
Impaired lung development due to bowel tissue blocking thorax
What are some risk factors for sepsis?
Choriamnionitis GBS positive Unwell mother Prolonged rupture of membranes Spontaneous labour under 35 weeks Respiratory distress Abnormal blood markers
What causes respiratory distress syndrome in preterms?
Sepsis
Respiratory distress syndrome/HMD
Wet lung
Congenital
Meconium aspiration syndrome
What is RDS?
Commonest cause of RD in preterms due to lack of surfactant in lung
When does surfactant arise? What triggers it?
33-34 weeks
Cortisol surge
What are risk/protective factors for RDS?
RFs • Prematurity • Asphyxia • Maternal diabetes • Second twin • Male • Family history
Protective
• Maturity
• Chronic stress
• Exogenous corEcosteroids • Family history
How is RDS managed?
Antenatal corticosteroids
Temperature control
Oxygen - 91-95% sat
CPAP, PEP, Intubate
Pink, warm, sweat
Abx
How is surfactant given?
Intubate, squirt it in
Minimally invasive
Which antibiotics are given in sepsis of the newborn/pneumonia?
IV BenzylPenicillin and Gentamicin
