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9 Cards in this Set
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- Back
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Requirements for Normal Pulmonary Transition
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1. lung maturity
(needs surface for gas xchange, surfactant, capillaries in the right place) 2.Lung fluid Reabsorption (fluid filled lungs don't exchange gas) 3. Fall in Pulm.Vasc.Resistance + Inc. in Syst. Vasc Resistance. |
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What change in the lungs allows them to start reabsorbing fluid?
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In utero, lungs are Cl- secreting!
hormone changes during labor cause alveolar epithelial cells to stop secreting Cl- and start absorbing Na+. fluid --> lymphatics --> venous sys. Water/Fluid is reabsorbed w/ Na+ |
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Why do premies + C section babies sometimes have trouble absorbing lung fluid?
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They weren't exposed to the hormonal changes during vaginal birth that switches off Cl- secretion and starts Na+ secretion!
NOT related to "vaginal squeeze" |
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What complications can you get from retained fetal lung fluid?
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- Transient Tachypnea of the Newborn
- Worsens RDS - Pneumonia (lungs are full of fluid) |
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What are the key things that happen during fetal transition?
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1. Cl- secreting --> Na+ absorbing to absorb alveolar fluid
2. umb. arteries and veins constrict to inc. SVR (normally low b/c placenta can't pump blood!) 3. oxygen +ventilation cause blood vessels in lung relax ( dec. PVR) NO+ PGI are released, relax vessels even more. 4. Pulm. Artery pressure falls. |
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What is the MOST important and effective action in neonatal resuscitation?
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positive pressure ventilation!!!
Way more important that chest compressions. This will inc. HR. |
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Why are premies at hi risk for abnormal transition?
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1. lack of surfactant
2. dec. drive to breathe 3. weak breathing muscles. 4. bad temp control, lots of heat loss. This is bad b/c: -at risk for brain hemorrhage, hypovolemia, tissues are at risk for O2 damage. |
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Newborn has grunting, cyanosis, nasal flaring, retractions. You can hear crackles. Chest xray shows air bronchograms.
What could this be? |
Respiratory Distress Syndrome!
a syndrome in premature infants caused by lack of surfactant production and structural immaturity in the lungs can cause: atelectasis, Pulm. edema, etc. prevent: matermal steroids trt: exogenous surfactant |
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pulmonary surfactant is made of
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phospholipids + ptns secreted by type II pneumocytes.
Major component is dipalmitoyl phosphatidylcholine *DPPC) |
