neonate

1. RESPIRATORY DISTRESS
IN
NEONATES

2. HYALINE MEMBRANE DISEASE/RDS
Most common cause of Respiratory distress in preterm neonates.
BASIC DEFECT: Deficiency of mature Surfactant
SURFACTANT COMPOSITION:
 DPPC(Dipalmitoyl Phosphatidylcholine) or Lecithin
 Phosphatidyl glycerol
 Cholesterol
 Surfactant protein A,B,C,D(B most important surfactant protein)
SYNTHESIS:
 Begins in fetal lungs-20weeks gestation.
 Begins to appear in amniotic fluid-28wks-32wks of gestation.
 Mature surfactant in adequate amount->35wks of gestation.

3. HYALINE MEMBRANE DISEASE
FUNCTION:
 To decrease surface tension of alveoli
 It prevents alveoli from collapsing during expiration.
PATHOPHYSIOLOGY OF RDS:
 Deficiency of mature surfactant
 ALVEOLAR COLLAPSE
 DIFFUSE ALVEOLAR DAMAGE
 INTERSTITIAL EDEMA
 FIBRIN DEPOSITION
EOSINOPHILIC
HYALINE MEMBRANE
APPEARANCE ON
LUNG
BIOPSY

4.  CPAP
PREVENTION:Inj
betamethasone12mg,2dose,24h
rs apart in 24-34wks gestation
in high risk women.
BENEFITS:Decrease
RDS,IVH,NEC,Neonatal mortality.

5. • GROUND GLASS HAZINESS OF LUNGS
• PRESENCE OF AIR BRONCHOGRAM
• RETICULO-GRANULAR OR NODULAR APPEARA
• FEATURES OF LUNG COLLAPSE

8. DIAGNOSIS:

9. DIAGNOSIS:

10. NEONATAL PULMONARY ALVEOLAR
PROTEINOSIS
 Deficiency of SURFACTANT PROTIEN B which forms a thin layer of surfactant in the
inner layer of alveoli.
 A term neonate presenting with severe RDS soon after birth with chest Xray
showing ground glass haziness.
 No improvement with surfactant therapy.
 H/O similar illness in a previous sibling who died.

11. MECONIUM ASPIRATION
SYNDROME
MECONIUM: First stool passed by a neonate;Greenish black in
colour;sterile
Comprises of:
 Amniotic fluid
 Bile(bile pigments & salts)
 Mucus
 Lanugo
 Denuded interstitial epithelial cels
 Water

12. PATHOPHYSIOLOGY
 Obstructive emphysema
 Chemical pneumonitis
 Segmental collapse or
atelectasis

13. CLINICAL FEATURE:
A term SGA/IUGR baby,born through meconium stained
liquor,presents with respiratory distress soon after birth.
On Examination: AP diameter of the chest increased
CXR findings:
 Hyperinflated lungs-Increased radiolucency of lungs;Flattening of domes of
diaphgram.
 Pulmonary infiltrates
 Segmental collapse

14. TREATMENT

15. TRANSIENT TACHYPNEA OF NEW
BORN
Most common cause of respiratory distress in a term neonate.
BASIC DEFECT: Delayed clearance of lung fluids.
RISK FACTOR: Delivery by caesarean section.
CLINICAL FEATURES:Term/Post term neonate,born by c section presents
with mild respiratory distress,soon after birth that improves
spontaneously in 48-72 hrs.
CXR FINDING:
 Fluid in interlobar fissure
 Plueral effusion
 Perhilar streaking(prominent broncho vascular
marking)

16. THANK YOU