1 / 22

Nonatology: Neonatal Respiratory Distress

Nonatology: Neonatal Respiratory Distress. Lecture Points. Neonatal pulmonary function Clinical Manifestation The main causes Main types of the disease Case discussion and presentation Summary and conclusion. Pulmonary function of the newborns in particular.

agrata
Download Presentation

Nonatology: Neonatal Respiratory Distress

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Nonatology: Neonatal Respiratory Distress

  2. Lecture Points • Neonatal pulmonary function • Clinical Manifestation • The main causes • Main types of the disease • Case discussion and presentation • Summary and conclusion

  3. Pulmonary function of the newborns in particular • Relative small capacity of the lungs： limited reserved volume  poor compensation, likely to be distressed • Respiratory on abdomen and diaphragmatic movement  Distension: likely to be respiratory distressed • pulmonary surfactant (PS) relative in small amount in preterms and easily to be deficiency • Diseased lungs trends poor compliance and even ARDS

  4. Neonatal Respiratory Distress General picture • commonly occurs during neonatal period caused by various pathogeneses • breath or 、irregular, apnea • With or without retraction at breathing, suprasternal and intercostal • usually with cyanosis more or less

  5. Causation of neonatal respiratory distress • Upper respiratory tract： choana, macrotongue, micrognathia • Larynx/throat and trachea：intenerate • pulmonary disease： inflamation、abnormality or hypogenesis • others：congenital heart disease metabolic problems, CNS caused

  6. Pathophysiology in neonatal respiratory distress hypoxic and /or hypoventilation  hypoxemia, PCO2  respiration center peripheral biochemical sensors  breath or 、irregular, apnea

  7. Neonatal Respiratory Distress • Hyaline Membrane Disease （HMD、RDS) • Neonatal infectious Pneumonia • Meconium Aspiration Syndrome (MAS) for differentiation

  8. Hyaline Membrane Disease（HMD/RDS） Clinical manifestation • preterms • normal at birth, respiratory distressed in several hours after birth • progressively developing and deterioration • self cured process during the sickness

  9. Neonatal infectious Pneumonia Clinical manifestation • After birth commonly seen, intrauterine infectious pneumonia relatively less seen • Occurring in neonates with different GAs and ages • General appearance of infection • Various in severity of respiratory distress • Blood-gas：PaO2  、PaCO2 

  10. Meconium Aspiration Syndrome (MAS) Clinical manifestation • Terms and post-terms commonly seen • History of intrauterine distress • amniotic fluidstained bymeconium • Lower Apgar’s score • Distress occurs soon after birth • Tachypnea and withdrawal at breathing • Blood-gas：PaO2 , PaCO2  and acidosis

  11. CXR:HMD

  12. CXR: pneumonia

  13. CXR:MAS

  14. CXR: MAS

  15. Clinical management for neonatal respiratory distress Monitoring • General appearance：T; response, skin color, feeding tolerance • respiration（frequency, pattern and apnea） • Other systems: HR, liver, abdomen • Blood-gas, Pa O2 、SaO2

  16. Clinical management for neonatal respiratory distress Oxygen therapy • Nasal tube • Mask and tent • Pressed facial mask Attention! fio2 O2 concentration ROP,CLD/BPD

  17. Clinical management for neonatal respiratory distress Mechanical ventilation • Target：early intervention and early withdraw • Indication： persistent cyanosis under oxygen therapy Remarkable SaO2  PaO2  and /or PaCO2 indicated by ABG

  18. Clinical management for neonatal respiratory distress Mechanical ventilation • Ventilation modes and parameters • Continuous positive airway pressure (CPAP)： 4 - 8 cmH2O; • Assistant/control (A/C) ： PIP 15-25 cmH2O；RR 25-35； I/E：1：1.5-2.5；PEEP： 4 - 12 cmH2O • Pressure support ventilation ( PSV )：6-10 cmH2O • High frequency oxillation ventilation: HFOV

  19. Clinical management for neonatal respiratory distress Medication • antibiotics penicillin: 10-40 万u/kg/d ampicillin: 50-75mg /kg/d cephalosporin: 25-50mg /kg/d • PS: 80-120 mg /kg, 1 to 2 dose

  20. Clinical management for neonatal respiratory distress Keep the baby warm • Incubator • Radiator • Stable room tempereture

  21. Clinical management for neonatal respiratory distress Clinical nutrition • Feeding:Breast milk/Formulas decreasing volume feeding as needed • Parenteral nutrition（T/PPN）

  22. Thanks for listening Questions please?

More Related