30. Neonatal respiratory distress syndrome Flashcards Preview

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Flashcards in 30. Neonatal respiratory distress syndrome Deck (21):
1

pathophysiology

surfactant deficiency --> increased alveolar surface tension---> alveolar collapse

2

lab test predictive for neonatal respiratory distress syndrome

1. lecithin/ sphingomyelin ratio in amniotic fluid -->if more than 2 ---> healthy
-if less than 1.5 ---> predictive of NRDAS
2. foam stability test
3. surfactn / albumin ration

3

neonatala repsiratory distress syndrome - CXR

ground glass apperance of lung fields

4

persistently low O2 tension - risk of

1. PDA
2. metabolic acidosis
3. necrotizing enterocolitis

5

therapeutic supplemental of O2 can result in

1. retinopathy of prematurity
2. intraventricular haemorrhage ( brain)
3. Bronchopulmonary dyplasia

6

Intraventricular hemorrhage of the newborn is ...

bleeding into the fluid - filled areas ( ventrivles ) inside the brain

7

risk factors

1. prematurity
2. maternal diabetes
3. C- section deliver

8

maternal diabetes as a risk factor of nrds

increased fetal insulin ( insulin decreases surfactant production )

9

c- section delivery as risk factor of nrds

lack of stress induced steroids ( steroids induce synthesis of surfactant )

10

nrds - tx

1. maternal steroids before birth
2. artificial surfactan for infant

11

clinical deature after birth

1. hypoxemia with cyanosis
2. increased respiratory efforts ( tachypnea, use of accessory muscles, grunting

12

• A newborn dies of neonatal respiratory distress syndrome. Lung tissue examined in the lab will reveal a deficiency of what chemical?

Surfactant

13

• How does the lack of surfactant in neonatal respiratory distress syndrome impair gas exchange in the lungs?

Surfactant deficiency leads to an increase in surface tension, resulting in collapse of the alveoli

14

• What is used as a measure of lung maturity in neonates? What values are expected in neonatal respiratory distress syndrome (NRDS)?

The lecithin:sphingomyelin ratio in amniotic fluid; <1.5 for NRDS

15

• What vascular pathology is associated with persistently low oxygen tension due to neonatal respiratory distress syndrome?

Patent ductus arteriosus

16

• A newborn is cautiously administered oxygen by a neonatologist, who also performs serial eye exams. What is the physician worried about?

Retinopathy of prematurity (a side effect of therapeutic supplemental oxygen administration in newborns with NRDS)

17

• A newborn receives supplemental oxygen therapy for neonatal respiratory distress syndrome. This can lead to what three complications?

Retinopathy of prematurity, Intraventricular hemorrhage, and Bronchopulmonary dysplasia (RIB)

18

• What are three risk factors for neonatal respiratory distress syndrome?

Prematurity, maternal diabetes (due to elevated insulin), and cesarean delivery (due to decreased release of fetal glucocorticoids)

19


• A premature infant born to a diabetic mother exhibits intercostal retractions and appears hypoxic. What is the most likely diagnosis?

Neonatal respiratory distress syndrome

20

A newborn diagnosed with neonatal respiratory distress syndrome is at risk of what complications?

Metabolic acidosis, PDA, necrotizing enterocolitis

21

• Medical treatment for neonatal respiratory distress syndrome includes what treatments for the mother and child?


Steroids for the mom prior to birth, and artificial surfactant for the newborn