Respiratory distress in newborn

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Respiratory distress in newborn

• 4th year seminar

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RDS

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

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signs

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

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Chest X-ray

• Ground glass appearance
• Reticulogranular
• With air bronchograms

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Physiologic abnormalities

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

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surfactant

• Type 2 pneumocytes lamillar body 22weeks34-36wks
• Phosphatidylcholine
• Surfactant specific protein
• Recycling and regeneration (including externally
  given surfactant)

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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

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Treatment

• Surfactant Fujiwara1990s
• Prevention
• rescue
• Supportive
• Thermal
• Fluid and nutrition
• oxygen
• Mechanical ventilation

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Acid base In RDS

• pH
• PaCO2
• PaO2
• HCO3
• Base deficit

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complications

• Pneumothorax
• PDA
• Chronic lung disease
• Sepsis
• Line problems

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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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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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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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