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Respiratory distress in newborn

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extremities puffy or swollen. Chest X-ray. Ground glass appearance. Reticulogranular ... Recycling and regeneration (including externally given surfactant) surfactant ... – PowerPoint PPT presentation

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Title: 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

5
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7
Physiologic abnormalities
  • Lung compliance 10-20 of norm
  • Atelectasisareas not ventilated
  • Areas not perfused
  • Decrease alveolar ventilation
  • Reduce lung volume

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9
surfactant
  • Type 2 pneumocytes lamillar body 22weeks34-36wks
  • 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 Fujiwara1990s
  • 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

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

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18
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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