respiratory distress syndrome and retinopathy of prematurity Flashcards
what is the pathology in RDS
lack of surfactant
what produces surfactant
type II pneumocytes
what happens if there isnt enough surfactant
alveolar collapse and inadequate gas exchange
who is RDS worse for M/F
M
can surfactant deficiency affect term babies
those with diabetic mothers
what to give antenatally if preterm is expected
Glucocorticoids
clinical signs of RDS
tachypnoea >60 breaths/min particularly sternal indrawing subcostal indrawing nasal flaring grunting cyanosis
how is supplementary oxygen given
nasal cannula CPAP
tracheal tube
how do you wean babies from oxygen therapy
High-flow humidified oxygen
therapy, via nasal cannulae
common complication of RDS
pneumothorax
signs of pneumothorax
breath sounds and chest movement on the affected side are reduced
how can you investigate pneumothorax
transillumination
how to treat tension pneumothorax
chest drain
common respiratory problems in preterm infants
apnoea and bradycardia
what is the common cause of apnoea and bradycardia in infants
immaturity of central respiratory control
how to resolve apnoea and bradycardia
gentle stimulation
where does ROP affect
junction of the vascular and nonvascularised retina
what happens in ROP
vascular proliferation
what pathology does vascular proliferation lead to
retinal detachment, fibrosis and blindness
what increases the risk of ROP
high concentrations of oxygen
resp distress investigation
chest X-ray
most common cause of RD in term babies
Transient tachypnoea of the newborn
cause of Transient tachypnoea
delay in the resorption of lung liquid
risk factor for Transient tachypnoea
C section
predispositions to pneumonia
Prolonged rupture of the membranes, chorioamnionitis and low birthweight
some causes of pneumothorax
meconium aspiration, respiratory distress syndrome or as a complication of ventilation
causes of Persistent pulmonary hypertension of
the newborn
asphyxia, meconium aspiration, septicaemia or RDS
pathology of PPHOTN
high pulmonary vascular resistance, there is right-to-left shunting within the lungs and at atrial and ductal levels
signs of PPHOTN
cyanosis
investigations of PPHOTN
chest x ray
echo
treatment of PPHOTN
ventilation, NO, sildenafil
wy are NO and sildenafil used in PPHOTN
vasodilators
when is diaphragmetic hernia mostly diagnosed
antenatally using ultrasound
diaphragmatic hernia presentation
failure to respond to resuscitation or as respiratory distress
auscultation of diaphragmatic hernia
apex beat and heart sounds displaced to the right side of the chest, with poor air entry in the left chest.
diaphragmatic hernia investigation
chest and abdo xray
management of diaphragmatic hernia
nasogastric tube is passed and suction is applied to prevent distension of the intrathoracic bowel
surgical repair of the hernia
DH sequely
pulmonary hypoplasia
