Respiratory Distress Flashcards
(37 cards)
Clinical features of respiratory distress: [5]
- persistent tachypnea
- central cyanosis
- sternocostal recession
- expiratory grunting
- nasal flaring
Predisposing Factors: [7]
- IDM
- Fetal distress
- chorioamnionitis
- complicated labour
- c-section
- preterm delivery
- underweight for gestational age
Causes of Respiratory Distress: Respiratory vs non-respiratory [12]
- HMD
- Wet lung syndrome
- Meconium Aspiration
- Pneumonia
- Chronic Lung disease
- Pneumothorax
- PPH of newborn
- CHD
- Hypothermia
- Anaemia or polycythemia
- Metabolic acidosis
- PDA
What inhibits synthesis of surfactant? [3]
- hypoxia
- acidosis
- hypothermia
What does an x-ray of HMD show? [2]
under-expanded chest with a fine reticulo-grandular appearance
When to give betamethasone?
And for how long should delivery be delayed when betamethasone is administered?
- before 34 weeks
- 48 hours
Maintenance of Pa02 in Respiratory distress caused by HMD -Management
- 7 to 10 kPa (50 to 80 mmHg)
complications associated with HMD: EARLY VS LATE
Early
- pneumothorax
- intraventricular hemorrhage
- heart failure d/t PDA
Late
CHRONIC LUNG DISEASE (Bronchopulmonary Dysplasia)
Xray differences between HMD, TTN, and Meconium aspiration
reticular granular appearance
hyperinflation, flattening of the diaphragm, fluid in the horizontal fissure of the right lung
hyperinflated chest, diaphragmatic flattening, cardiomegaly, atelectasis, and consolidation
what are the risks associated with meconium aspiration [4]
- pneumothorax
- pneumomediastinum
- pph
- pneumonitis due to irritation
what is responsible for pneumonia in an infant before or during the passage through the birth canal and when does it occur? [2]
group b haemolytic streptococci and ecoli
within 72 hours
Pneumonia can cause a disease. What is it? [1]
chorioamnionitis
syphilis may cause [1]
pneumonia
nosocomial pneumonia is caused by
What does a newborn with pneumonia present like? [1]
staph aureus
kleibsella
pseudomonas
apneoic spells and needs to be confirmed with chest x ray
common causes for pneumothorax in infant
- meconium aspiration
- vigorous resus after birth
- HMD
- spontaneous
when does apnoea of prematurity occur
affects infants born before 34 weeks
what is the treatment of apnoea of prematurity and who is usually affected by it?
caffeine citrate
infants born before 34 weeks
when are signs of anemia of prematurity seen
4 to 8 weeks
What causes HMD? [2]
- surfactant deficiency
- poorly controlled diabetic mothers
What does surfactant do?
surfactant lowers surface tension in the alveoli and allows respiration with minimal effort. Lack of surfactant leads to alveoli collapse.
Clinical signs of HMD:
normal clinical signs of respiratory distress
Tell me when is HMD worse and how will the baby look? Also, tell me when is it best to prevent HMD.
72 hours, frog position.
Before 39 weeks.
What is the goal of management in HMD? Remember surfactant and what it does. [4] AND ONE IMPORTANT ASPECT OF TREATMENT
- prevent worsening of alveolar collapse
- maintain oxygen saturation at 88-92%
- maintain blood glucose and temperature levels
- provide adequate nutrition
RELIEF OF HYPOXIA
If respiratory distress worsens in HMD, what do you do?
Give IN AND OUT surfactant therapy called LISA
