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40 Cards in this Set
- Front
- Back
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Respiratory Distress Syndrome (RDS)
Definition |
Condition of a newborn marked by dyspnea and cyanosis with signs of respiratory distress caused by formation of hyaline membranes that lines terminal respiratory passages due to decreased surfactant
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Respiratory Distress Syndrome (RDS)
Pathophysiology |
•Lack of surfactant increases surface tension
•Atelectasis increases •Compliance decreases •FRC decreases •Increases WOB •Hypoxemia •V/Q mismatch •Respiratory distress •Respiratory acidosis •Increases in Pulmonary vascular resistance •Causes decrease in blood flow and leads to R – L shunt |
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Respiratory Distress Syndrome (RDS)
Etiology |
•Prematurity pulmonary system
•Incidence is 50,000pre – term births 30% result in death •Risk factors are pre – maturity, weight < 1200 g., prenatal maternal conditions |
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Respiratory Distress Syndrome (RDS)
Clinical Manifestations |
•Tachypnea,/labored breathing > 60
•Retractions, expiratory grunting •Nasal flaring, decreased air entry •Cyanosis •CXR – white out, reticulogranular, ground glass appearance, air bronco gram with sever atelectasis •ABG – hypoxemia, hypercarbia |
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Respiratory Distress Syndrome (RDS)
Treatment |
•Prevention
•Supplemental O2 •Surfactant replacement •CPAP •ECMO •Monitoring •Thermoregulation •Glucose monitoring •Fluid regulation •Diuretics •PO2 – 50 – 80 •PCO2 < 60 •pH > 7.25 |
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Transient Tachypnea of the New Born
Definition |
Temporary disorder delaying in lung fluid absorption causing tachypnea and signs of respiratory distress
•Resolves in 24 hours •11 out of 1000 births •23 % following C - section |
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Transient Tachypnea of the New Born
Pathophysiology |
Fluid retention leading to:
•Decreased compliance •Decreased tidal volume •Increased work of breathing |
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Transient Tachypnea of the New Born
Etiology |
C – section deliver or rapid vaginal delivery
•Maternal fluid administration •Analgesic during labor |
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Transient Tachypnea of the New Born
Clinical Manifestations |
Occurs within 14 hours of delivery
•Infant shows signs of distress •RR – 60 - 150 •Grunting, retractions. Nasal flaring |
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Transient Tachypnea of the New Born
Treatment |
Supplemental O2
•Oxyhood < 40 % •Nasal cannula •CPAP ( 3 – 5 cm H2O) Prognosis •Full recovery usually within 24 hours |
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Neonatal Pneumonia
Definition |
Acquired pulmonary infection that occurs from introduction of an organism into the lungs in utero during delivery or post – nataly by cross contamination
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Neonatal Pneumonia
Etiology |
•In utero maternal viral or bacterial infection
•Peritinateal acquired during labor and delivery through contamination in amniotic fluid or vaginal tract bacteria •Horizontal transmission •Hyaline membranes, inactivation of surfactant |
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Neonatal Pneumonia
Clinical Manifestations |
•Tachypnea
•Cyanosis •increased HR •CXR – acquired in = utero – bilateral infiltrates •CXR acquired peri or post natal – patchy infiltrates |
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Neonatal Pneumonia
Treatment |
•Antibiotic/antiviral
•Oxygen, possible mechanical ventilation Depends on organism. •Ability to treat and complications affecting outcome |
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Respiratory Distress Syndrome (RDS)
Definition |
Condition of a newborn marked by dyspnea and cyanosis with signs of respiratory distress caused by formation of hyaline membranes that lines terminal respiratory passages due to decreased surfactant
|
|
|
Respiratory Distress Syndrome (RDS)
Pathophysiology |
•Lack of surfactant increases surface tension
•Atelectasis increases •Compliance decreases •FRC decreases •Increases WOB •Hypoxemia •V/Q mismatch •Respiratory distress •Respiratory acidosis •Increases in Pulmonary vascular resistance •Causes decrease in blood flow and leads to R – L shunt |
|
|
Respiratory Distress Syndrome (RDS)
Etiology |
•Prematurity pulmonary system
•Incidence is 50,000pre – term births 30% result in death •Risk factors are pre – maturity, weight < 1200 g., prenatal maternal conditions |
|
|
Respiratory Distress Syndrome (RDS)
Clinical Manifestations |
•Tachypnea,/labored breathing > 60
•Retractions, expiratory grunting •Nasal flaring, decreased air entry •Cyanosis •CXR – white out, reticulogranular, ground glass appearance, air bronco gram with sever atelectasis •ABG – hypoxemia, hypercarbia |
|
|
Respiratory Distress Syndrome (RDS)
Treatment |
•Prevention
•Supplemental O2 •Surfactant replacement •CPAP •ECMO •Monitoring •Thermoregulation •Glucose monitoring •Fluid regulation •Diuretics •PO2 – 50 – 80 •PCO2 < 60 •pH > 7.25 |
|
|
Transient Tachypnea of the New Born
Definition |
Temporary disorder delaying in lung fluid absorption causing tachypnea and signs of respiratory distress
•Resolves in 24 hours •11 out of 1000 births •23 % following C - section |
|
|
Transient Tachypnea of the New Born
Pathophysiology |
Fluid retention leading to:
•Decreased compliance •Decreased tidal volume •Increased work of breathing |
|
|
Transient Tachypnea of the New Born
Etiology |
C – section deliver or rapid vaginal delivery
•Maternal fluid administration •Analgesic during labor |
|
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Transient Tachypnea of the New Born
Clinical Manifestations |
Occurs within 14 hours of delivery
•Infant shows signs of distress •RR – 60 - 150 •Grunting, retractions. Nasal flaring |
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Transient Tachypnea of the New Born
Treatment |
Supplemental O2
•Oxyhood < 40 % •Nasal cannula •CPAP ( 3 – 5 cm H2O) Prognosis •Full recovery usually within 24 hours |
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Neonatal Pneumonia
Definition |
Acquired pulmonary infection that occurs from introduction of an organism into the lungs in utero during delivery or post – nataly by cross contamination
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|
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Neonatal Pneumonia
Etiology |
•In utero maternal viral or bacterial infection
•Peritinateal acquired during labor and delivery through contamination in amniotic fluid or vaginal tract bacteria •Horizontal transmission •Hyaline membranes, inactivation of surfactant |
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Neonatal Pneumonia
Clinical Manifestations |
•Tachypnea
•Cyanosis •increased HR •CXR – acquired in = utero – bilateral infiltrates •CXR acquired peri or post natal – patchy infiltrates |
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Neonatal Pneumonia
Treatment |
•Antibiotic/antiviral
•Oxygen, possible mechanical ventilation Depends on organism. •Ability to treat and complications affecting outcome |
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Meconium Aspiration Syndrome
Definition |
Develops from aspirated meconium stained (bowel content) amniotic fluid in – utero causing airway obstruction, air trapping and bacterial infection post – delivery
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Meconium Aspiration Syndrome
Pathophysiology |
Amount and viscosity of meconium determine severity of obstruction
Atelectasis V/Q mismatch pneumonia |
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Meconium Aspiration Syndrome
Etiology |
•Fetal stress or post - term
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Meconium Aspiration Syndrome
Clinical Manifestations |
•Meconium stained fluid present
•Post – term infant appearance •APGARS deteriorate •Signs of distress |
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Meconium Aspiration Syndrome
Incidence: |
Meconium staining – 8 – 15% of all deliveries with 5% acquiring aspiration
Seen in infants > 36 weeks gestation Increased incidence post term > 42 weeks |
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Meconium Aspiration Syndrome
Treatment |
Intubate/mechanically ventilate
SUCTION Surfactant replacement ECMO •Partial liquid ventilation |
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Meconium Aspiration
Prognosis |
Most infants survive but develop BPD
on Syndrome |
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Persistent Pulmonary Hypertension of the New Born
Definition |
Syndrome in which pulmonary arteries remain tightly constricted causing high pulmonary vascular resistance
Incidence: Increases with intrauterine stress Meconium aspiration, RDS, TTN CHD |
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Persistent Pulmonary Hypertension of the New Born
Pathophysiology |
•Failure to lower PVR or pulmonary vascular hypereacts to stimuli causing a reversal of PV relaxation
•Constriction maintains R – L shunt |
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Persistent Pulmonary Hypertension of the New Born
Etiology |
•PVR/SVR >1
•Increased anatomic shunts •At the foramen ovale or ductus arteriosus |
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Persistent Pulmonary Hypertension of the New Born
Clinical Manifestations |
With in 12 hours infant shows signs of distress
•Refractory hypoxemia |
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Persistent Pulmonary Hypertension of the New Born
Treatment • |
• Differential diagnosis to rule out RDS, CHD
• Hyperoxia – hyperventilation test •O2 therapy, mechanical ventilation •Pharmacologic support ( Theophyline, doxapram) •Nitric oxide Prognosis •Mortality rate 20 –40 % •12 – 32 % survivors suffer |
