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14 Cards in this Set
- Front
- Back
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What's defined as apnea?
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Respiratory pause of 20 seconds or more
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Where can the problem be causing apnea?
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-Central - no respiratory effort
-Obstructive - upper airway obstruction -Mixed |
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What can cause apnea?
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1.Apnea of prematurity (dx of exclusion)
2.CV (PDA, PGE infusion) 3.Resp (hypoxemia, airway occlusion, atelectasis) 4. ID Infection (sepsis, meningitis, PNA) 3.GI - NEC, GERD, feeding bradycardia 4.Neuro - intracranial hemorrhage, hydrocephalus, seizures 5.Heme - polycythemia, anemia 6.Endo - hypoglycemia 7.Other - medications, drug withdrawal |
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Who is at risk for apnea of prematurity?
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Infants less than 32 wk.
Usu stop by 37 wk. |
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Term infants breathing is stimulated by what?
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CO2 levels (like adults)
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Preterm infants breathing is stimulated by what?
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They have a blunted response to CO2
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Why do you get bradycardia?
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Hypoxia --> hyperventilation --> hypoventilation --> bradycardia follows.
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What sleep cycle does apnea occurs in?
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REM sleep. Decrease percentage of time in REM sleep as infant gets older.
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What can you do for infants with apnea?
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1.Caffeine
2.Nasal CPAP 3.Ventilator |
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What is BPD?
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Bronchopulmonary dysplasia
-Infants who require supplemental oxygen after 28 days of age and lung parenchyma is abnormal on CXR |
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Who is at risk for BPD?
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-Low weight infants ventilated for RDA
-PDA -Excessive fluid intake -Exposure to oxygen |
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What's the pathogenesis of BPD?
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-Injury of alveoli and airways
- Fibrosis and excess lung fluid reduce compliance, and airways become narrow, fibrotic, and hyperactive |
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What do you see with BPD?
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1.Tachypnea, retraction, wheezing and rales
2.ABG: hypoxemia, hypercarbia --> metabolic compensation 3.CXR : diffuse haziness --> hyperinfaltion and hyperlucent areas with streaky densities. |
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How do you treat BPD?
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1.Minimize airway pressures and accept higher CO2/ lower O2
2.Early use of surfactant 3.Early management of PDA 4.Strict fluid management 5.Diuretics -Lasix -Chlorothiazide and spironolactone 6.Bronchodilators -Albuterol -Theophylline, Cromolyn 7.Steroids -Decadron |
