Respiratory distress in newborn

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

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

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

10. 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

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

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

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

14. 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

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

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