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Respiratory distress in newborn

Respiratory distress in newborn. 4 th year seminar. RDS. Most common respiratory illness in NICU Occur in premature neonate Surfactant deficiency Risk factors Asphyxia and stress Male Acidosis DM mother. signs. tachypnea retraction grunting Nasal flaring apneic episode cyanosis

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Respiratory distress in newborn

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  1. Respiratory distress in newborn 4th year seminar

  2. RDS • Most common respiratory illness in NICU • Occur in premature neonate • Surfactant deficiency • Risk factors • Asphyxia and stress • Male • Acidosis • DM mother

  3. signs • tachypnea • retraction • grunting • Nasal flaring • apneic episode • cyanosis • extremities puffy or swollen

  4. Chest X-ray Ground glass appearance Reticulogranular With air bronchograms

  5. Physiologic abnormalities • Lung compliance 10-20% of norm • Atelectasis…areas not ventilated • Areas not perfused • Decrease alveolar ventilation • Reduce lung volume

  6. surfactant • Type 2 pneumocytes lamillar body 22weeks…34-36wks • Phosphatidylcholine • Surfactant specific protein • Recycling and regeneration (including externally given surfactant)

  7. surfactant • Decrease surface tension at air liquid level • Equalize tension in alveoli of different size • Increase in lung compliance. • Absence of surfactant cause RDS • Pulmonary hypertension

  8. Treatment • Surfactant Fujiwara…1990s • Prevention • rescue • Supportive • Thermal • Fluid and nutrition • oxygen • Mechanical ventilation

  9. Acid base In RDS • pH • PaCO2 • PaO2 • HCO3 • Base deficit

  10. complications • Pneumothorax • PDA • Chronic lung disease • Sepsis • Line problems

  11. Meconium aspiration • First stool that constitutes the GI epithilium and secretion during fetal life • Stress and intra-uterine meconium in term infant • Gasping cause the aspiration • Chemical diffuse peumonitis • Same signes of distrss and PPHN. • Treatment maily supprtive

  12. Congenital pneumonia • Sepsis risk factors • PROM • Preamturity • Maternal fever, dicharge, abdominal pain, leukocytosis • Colonization with GBS • Same signs of RDS • X-ray

  13. Transient tachypnia of newborn • Term • Cesarian delivery • Usually tachypnia without O2 requirment • Resolve in 48-72 houres • Lung fluid • X-ray

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