Surfactant_Deficient_Lung_Disease_Flashcards
What is surfactant deficient lung disease (SDLD)?
Surfactant deficient lung disease (SDLD) is a condition seen in premature infants caused by insufficient surfactant production and structural immaturity of the lungs.
What are other names for surfactant deficient lung disease?
Other names for surfactant deficient lung disease include respiratory distress syndrome and previously hyaline membrane disease.
What causes surfactant deficient lung disease?
SDLD is caused by insufficient surfactant production and structural immaturity of the lungs.
How does the risk of SDLD change with gestation?
The risk of SDLD decreases with gestation.
What percentage of infants born at 26-28 weeks develop SDLD?
50% of infants born at 26-28 weeks develop SDLD.
What percentage of infants born at 30-31 weeks develop SDLD?
25% of infants born at 30-31 weeks develop SDLD.
What are other risk factors for SDLD?
Other risk factors for SDLD include male sex, diabetic mothers, Caesarean section, and being the second born of premature twins.
What are the clinical features of SDLD?
The clinical features of SDLD are those common to respiratory distress in the newborn: tachypnoea, intercostal recession, expiratory grunting, and cyanosis.
What does a chest x-ray characteristically show in SDLD?
A chest x-ray in SDLD characteristically shows a ‘ground-glass’ appearance with an indistinct heart border.
What are the management strategies for SDLD?
Management strategies for SDLD include maternal corticosteroids during pregnancy to induce fetal lung maturation, oxygen, assisted ventilation, and exogenous surfactant given via endotracheal tube.
How can SDLD be prevented during pregnancy?
SDLD can be prevented during pregnancy by administering maternal corticosteroids to induce fetal lung maturation.
What treatments are used for SDLD in newborns?
Treatments for SDLD in newborns include oxygen, assisted ventilation, and exogenous surfactant given via endotracheal tube.
summarise surfuctant deficient lung disease
Surfactant deficient lung disease
Surfactant deficient lung disease (SDLD, also known as respiratory distress syndrome and previously as hyaline membrane disease) is a condition seen in premature infants. It is caused by insufficient surfactant production and structural immaturity of the lungs
The risk of SDLD decreases with gestation
50% of infants born at 26-28 weeks
25% of infants born at 30-31 weeks
Other risk factors for SDLD include
male sex
diabetic mothers
Caesarean section
second born of premature twins
Clinical features are those common to respiratory distress in the newborn, i.e. tachypnoea, intercostal recession, expiratory grunting and cyanosis
Chest x-ray characteristically shows ‘ground-glass’ appearance with an indistinct heart border
Management
prevention during pregnancy: maternal corticosteroids to induce fetal lung maturation
oxygen
assisted ventilation
exogenous surfactant given via endotracheal tube
A neonate is born at 32 weeks gestation via spontaneous vaginal delivery. There was no meconium staining of the liquor. Shortly after delivery he develops cyanosis, tachypnoea, grunting and sternal recession. What is the most likely diagnosis?
Neonatal respiratory distress syndrome (NRDS)
Aspiration pneumonia
Transient tachypnoea of the newborn
Pneumothorax
Cyanotic heart disease
Neonatal respiratory distress syndrome (NRDS)
It is important to be aware of risk factors when answering questions like these. Prematurity is the major risk factor for NRDS. Caesarean section is the major risk factor for tachypnoea of the newborn (TTN). Meconium staining is the major risk factor for aspiration pneumonia.
Neonates with NRDS usually present with respiratory distress shortly after birth which usually worsens over the next few days. In contrast, TTN usually presents with tachypnoea shortly after birth and often fully resolves within the first day of life. A chest radiograph can be useful. In NRDS the characteristic features are a diffuse ground glass lungs with low volumes and a bell-shaped thorax. In TTN the CXR depicts a heart failure type pattern (e.g. interstitial oedema and pleural effusions) but key distinguishing features from congenital heart disease are a normal heart size and rapid resolution of the failure type pattern within days.
