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14 Cards in this Set

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What's defined as apnea?
Respiratory pause of 20 seconds or more
Where can the problem be causing apnea?
-Central - no respiratory effort
-Obstructive - upper airway obstruction
-Mixed
What can cause apnea?
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
Who is at risk for apnea of prematurity?
Infants less than 32 wk.
Usu stop by 37 wk.
Term infants breathing is stimulated by what?
CO2 levels (like adults)
Preterm infants breathing is stimulated by what?
They have a blunted response to CO2
Why do you get bradycardia?
Hypoxia --> hyperventilation --> hypoventilation --> bradycardia follows.
What sleep cycle does apnea occurs in?
REM sleep. Decrease percentage of time in REM sleep as infant gets older.
What can you do for infants with apnea?
1.Caffeine
2.Nasal CPAP
3.Ventilator
What is BPD?
Bronchopulmonary dysplasia
-Infants who require supplemental oxygen after 28 days of age and lung parenchyma is abnormal on CXR
Who is at risk for BPD?
-Low weight infants ventilated for RDA
-PDA
-Excessive fluid intake
-Exposure to oxygen
What's the pathogenesis of BPD?
-Injury of alveoli and airways
- Fibrosis and excess lung fluid reduce compliance, and airways become narrow, fibrotic, and hyperactive
What do you see with BPD?
1.Tachypnea, retraction, wheezing and rales
2.ABG: hypoxemia, hypercarbia --> metabolic compensation
3.CXR : diffuse haziness --> hyperinfaltion and hyperlucent areas with streaky densities.
How do you treat BPD?
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