L4: Neonatal Respiratory Diseases & Cyanosis Flashcards
(70 cards)
1
Q
Def of Neonatal Respiratory Distress
A
2
Q
Etiology of Neonatal Respiratory Distress
A
3
Q
Etiology of Neonatal Respiratory Distress
- Respiratory
A
4
Q
Etiology of Neonatal Respiratory Distress
- Respiratory (Pulmonary)
A
5
Q
Etiology of Neonatal Respiratory Distress
- Respiratory (Airway obstruction)
A
6
Q
Etiology of Neonatal Respiratory Distress
- CVS
A
7
Q
Etiology of Neonatal Respiratory Distress
- Neurologic Causes
A
- hypoxic ischemic encephalopathy
- Intraventricular hemorrhage
- Meningitis and Encephalitis
- Seizure
8
Q
Etiology of Neonatal Respiratory Distress
- Hematologic Disorders
A
- anemia
- Polycythemia
9
Q
Etiology of Neonatal Respiratory Distress
- Metabolic Disorders
A
- Hypoglycemia
- metabolic acidosis
10
Q
Etiology of Neonatal Respiratory Distress
- Miscellaneous Disorders
A
- Sepsis
- Hypothermia
- Hyperthermia
- congenital diaphragmatic hernia
- phrenic nerve paralysis
- pleural effusion
11
Q
Def of Transient Tachypnea of Newborn (TTN)
A
- It is a self-limited disease present within first few hours of life with tachypnea and increased oxygen requirement.
12
Q
Incidence of Transient Tachypnea of Newborn (TTN)
A
- It can occur in both term and preterm neonates.
- it is the most common cause of respiratory distress in the full-term infant.
13
Q
Etiology of Transient Tachypnea of Newborn (TTN)
A
Unknown, but it is believed to be due to delayed drainage of fetal lung fluid.
14
Q
RF for Transient Tachypnea of Newborn (TTN)
A
The incidence may be increased in:
▪ Male infants + Infants born via caesarean section.
15
Q
CP of Transient Tachypnea of Newborn (TTN)
A
- Tachypnea immediately after birth and persists for 24-48 h.
- Occasionally grunting and nasal flaring.
16
Q
INVx for Transient Tachypnea of Newborn (TTN)
A
17
Q
INVx for Transient Tachypnea of Newborn (TTN)
- Labs
A
Arterial blood gases reveals:
▪ Respiratory acidosis and mild-to moderate hypoxemia.
18
Q
INVx for Transient Tachypnea of Newborn (TTN)
- Rads
A
19
Q
TTT of Transient Tachypnea of Newborn (TTN)
A
- TTN is generally a benign, self-limited disease that usually responds well to oxygen therapy.
- Mechanical ventilation seldom “rare” is needed.
- Many infants require nasal continuous positive airway pressure (CPAP) support.
20
Q
Prognosis of Transient Tachypnea of Newborn (TTN)
A
Full recovery is expected within 2 to 5 days
21
Q
Incidence of Meconium Aspiration Syndrome
A
- It occurs in approximately 10% to 25% of all deliveries.
- It occurs almost exclusively in term and post-term deliveries.
22
Q
Pathogenesis of Meconium Aspiration Syndrome
A
23
Q
CP of Meconium Aspiration Syndrome
A
24
Q
INVx for Meconium Aspiration Syndrome
A
25
TTT of **Meconium Aspiration Syndrome**
26
TTT of **Meconium Aspiration Syndrome**
- Immediate TTT
- Suctioning the oropharynx and trachea before the first breath and before resuscitation if the baby is flaccid and not vigorous.
27
TTT of **Meconium Aspiration Syndrome**
- General TTT
- Endotracheal intubation and suctioning may be indicated to remove meconium from the airway if there is airway obstruction.
- Empty the stomach to avoid further aspiration.
28
TTT of **Meconium Aspiration Syndrome**
- Specific Lines
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Another Name of **RDS**
Hyaline Membrane Disease
30
Incidence of **RDS**
31
Pathogenesis of **RDS**
32
RF for **RDS**
33
INVx for **RDS**
34
INVx for **RDS**
- Labs
35
INVx for **RDS**
- Rads
36
Prevention of **RDS**
37
TTT of **RDS**
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TTT of **RDS**
- General
- The baby needs to be nursed in a neonatal intensive care unit.
- Basic support including thermal regulation and parenteral fluid
- Mild cases may only need oxygen (warm and humidified) via head box or nasal cannula.
39
TTT of **RDS**
- Specific
Surfactant replacement therapy:
▪ Given by instillation down endotracheal tube.
▪ Often improves pulmonary mechanics.
▪ Decreases RDS severity and reduces mortality.
40
TTT of **RDS**
- Respiratory Support
Continuous positive air pressure (CPAP):
▪ Can help to prevent alveolar and airway collapse.
Mechanical ventilation may be required:
▪ If the patient continues to deteriorate.
41
CPAP
- It is a continuous flow of a mixture of O2 and air past the infant's airway at a set pressure of 5-8 cm H20 maintaining an elevated end-expiratory lung volume while the infant breaths spontaneously.
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Prognosis of **RDS**
43
Incidence of **Air Leak Syndrome**
- Mostly seen in infants with lung disease who are on ventilatory support and may occur spontaneously.
- The more severe the lung disease, the higher the incidence of pulmonary air leak.
44
Types of **Air Leak Syndromes**
- Pneumomediastinum.
- Pneumothorax.
- pulmonary interstitial emphysema.
- pneumopericardium.
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Pathogenesis of **Air Leak Syndrome**
Overdistension of alveolar sacs or terminal airways ----> disruption of airway integrity ----> dissection of air into surrounding spaces.
46
RF for **Air Leak Syndrome**
- Ventilatory support
- Meconium aspiration syndrome
- Vigorous resuscitation.
47
CP of **Air Leak Syndrome**
48
INVx for **Air Leak Syndrome**
49
Prevention of **Air Leak Syndrome**
judicious use of ventilatory support and self-inflating bags.
50
TTT of **Air Leak Syndrome**
51
Types of **Pneumonia in Newborn**
52
Etiology of **Pneumonia in Newborn**
Most common causes
- Group B streptococci, Escherichia coli, Klebsiella and listeria.
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RF for **Pneumonia in Newborn**
- Prematurity.
- Premature rupture of the membranes.
- Chorioamnionitis.
- Maternal fever.
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CP of **Pneumonia in Newborn**
55
INVx for **Pneumonia in Newborn**
56
INVx for **Pneumonia in Newborn**
- Labs
ABG.
CBC.
Cultures.
57
INVx for **Pneumonia in Newborn**
- Rads
58
TTT of **Pneumonia in Newborn**
59
CP of **Congenital Heart Disease**
60
Infants who have CHD may present with .......
cyanosis or heart failure
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Infants who have isolated CHD usually do not have .......
hypercapnia
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Metabolic acidosis is slightly more common in patients who have low COP because of CHD.
...
63
Signs that are generally consistent with CHD include .....
64
Infants who have cyanotic heart diseases
- Typically, do not present with severe chest retraction however, tachypnoea is common
...
65
Infants who have cyanotic heart diseases
- Oxygen saturation is usually decreased
....
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Infants who have cyanotic heart diseases
- Increasing the concentration of inspired oxygen to 100% for 20 minutes (hyperoxia test) will not produce a significant increase in Pao2.
...
67
Value of (hyperoxia test)
Suggests the origin of cyanosis.
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Method of (hyperoxia test)
69
Results of (hyperoxia test)
70
INVx for **Congenital Heart Disease**
Echo:
- It is the definitive investigation.
