Respiratory distress syndrome

Question 1

who does this affect?

Answer 1

preterm neonates born before lungs produce surfactant
<32 weeks
males
twins

Question 2

chest x-ray

Answer 2

ground glass

Question 3

pathophysiology

Answer 3

inadequate surfactant
high surface tension within alveoli
atelectasis - more difficult to expand
inadequate gas exchange

Question 4

atelectasis

Answer 4

lung collapse

Question 5

inadequate gas exchange results in..

Answer 5

hypoxia
hypercapnia
resp distress

Question 6

antenatal management

Answer 6

steroids

increase production surfactant

Question 7

CPAP

Answer 7

via nasal mask to help keep lungs inflated whilst breathing

Question 8

oxygen sats preterm

Answer 8

91-95%

Question 9

short term complications

Answer 9

pneumothorax
infection 
apnoea 
necrotising enterocolitis
IVH
pulmonary haemorrhage

Question 10

long term complications

Answer 10

bronchopulmonary dysplasia
retinopathy of prematurity
neurological, hearing, visual impairment

Question 11

% premature babies affected

Answer 11

91% 23-25 weeks

52% 30-31 weeks

Question 12

what does hypoxia lead to?

Answer 12

reduced cardiac output
hypotension
acidosis
renal failure

Question 13

features

Answer 13

grunting 
nasal flaring
increased work breathing
intercostal recession 
cyanosis

Question 14

Treatment

Answer 14

delayed clamping cord
oxygen-air blender 
CPAP
intubate 
sufactant

Question 15

differentials

Answer 15

TTN

meconium aspiration

Question 16

TTN

Answer 16

fluid in lungs
resolves after 24 hours
c section term babies