This document discusses infant respiratory distress syndrome (IRDS), including its causes, signs and symptoms, diagnostic evaluation, treatment and nursing management. IRDS is caused by a lack of surfactant in premature infants' lungs. It can cause respiratory distress seen as tachypnea, retractions and grunting. Diagnosis involves blood tests and chest x-rays showing atelectasis. Treatment includes oxygen therapy, surfactant replacement, ventilation support and ensuring temperature and nutrition. Nursing care focuses on monitoring breathing and oxygen levels, preventing hypothermia and infection, and supporting nutrition and developmental care.
Surfactant replacement therapy : RDS & beyondDr-Hasen Mia
This presentation is about Surfactant, its use in Respiratory Distress Syndrome & some other conditions of surfactant deficiency due to inactivation like meconium aspiration syndrome & others
RESPIRATORY DISTRESS SYNDROME, PREVIOUSLY HYALINE MEMBRANE DISEASE IS A COMMON COMPLICATION OF PREMATURITY WITH MORTALITY ALMOST 100% IN THE ABSENCE OF PULMONARY SURFACTANT ADMINISTRATION, ESPECIALLY IN LOW RESOURCE SETTINGS LIKE OURS.
Surfactant replacement therapy : RDS & beyondDr-Hasen Mia
This presentation is about Surfactant, its use in Respiratory Distress Syndrome & some other conditions of surfactant deficiency due to inactivation like meconium aspiration syndrome & others
RESPIRATORY DISTRESS SYNDROME, PREVIOUSLY HYALINE MEMBRANE DISEASE IS A COMMON COMPLICATION OF PREMATURITY WITH MORTALITY ALMOST 100% IN THE ABSENCE OF PULMONARY SURFACTANT ADMINISTRATION, ESPECIALLY IN LOW RESOURCE SETTINGS LIKE OURS.
Pneumothorax is one of the most common air leak syndromes that occurs more frequently in the neonatal period than in any other period of life and is a life-threatening condition associated with a high incidence of morbidity and mortality.
Presented by Dr. Rupom
A powerpoint presentation on the respiratory illness seen in newborns/neonates.
the diseases mentioned in this presentation are among the most commonly seen in the population.
Pneumothorax is one of the most common air leak syndromes that occurs more frequently in the neonatal period than in any other period of life and is a life-threatening condition associated with a high incidence of morbidity and mortality.
Presented by Dr. Rupom
A powerpoint presentation on the respiratory illness seen in newborns/neonates.
the diseases mentioned in this presentation are among the most commonly seen in the population.
Nursing care management of child with respiratory distressMounika Bhallam
NURSING CARE MANAGEMENT OF CHILD WITH RESPIRATORY DISTRESS; this topic will give information regarding respiratory distress and management for mild and moderately distressed child. Mainly mentioned about infection prevention and control triage measures.
Pre-term, Small for gestational age and Post-term InfantLipi Mondal
Due to high risk of pregnancy there are several adverse outcome or poor perinatal outcome we can see.... So most commonly adverse out come should be known by health care providers.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
Earliest Galaxies in the JADES Origins Field: Luminosity Function and Cosmic ...Sérgio Sacani
We characterize the earliest galaxy population in the JADES Origins Field (JOF), the deepest
imaging field observed with JWST. We make use of the ancillary Hubble optical images (5 filters
spanning 0.4−0.9µm) and novel JWST images with 14 filters spanning 0.8−5µm, including 7 mediumband filters, and reaching total exposure times of up to 46 hours per filter. We combine all our data
at > 2.3µm to construct an ultradeep image, reaching as deep as ≈ 31.4 AB mag in the stack and
30.3-31.0 AB mag (5σ, r = 0.1” circular aperture) in individual filters. We measure photometric
redshifts and use robust selection criteria to identify a sample of eight galaxy candidates at redshifts
z = 11.5 − 15. These objects show compact half-light radii of R1/2 ∼ 50 − 200pc, stellar masses of
M⋆ ∼ 107−108M⊙, and star-formation rates of SFR ∼ 0.1−1 M⊙ yr−1
. Our search finds no candidates
at 15 < z < 20, placing upper limits at these redshifts. We develop a forward modeling approach to
infer the properties of the evolving luminosity function without binning in redshift or luminosity that
marginalizes over the photometric redshift uncertainty of our candidate galaxies and incorporates the
impact of non-detections. We find a z = 12 luminosity function in good agreement with prior results,
and that the luminosity function normalization and UV luminosity density decline by a factor of ∼ 2.5
from z = 12 to z = 14. We discuss the possible implications of our results in the context of theoretical
models for evolution of the dark matter halo mass function.
2. INTRODUCTION
Infant respiratory distress syndrome (IRDS), also called
‘NRDS’ or hyaline membrane disease, is a syndrome caused in
premature infants by developmental insufficiency of
‘surfactant’ production and structural immaturity in the lungs.
It can also result from a genetic problem with the production
of surfactant associated proteins.
Respiratory distress is the highest risk in long term respiratory
& neurologic complications.
3. Respiratory Distress Syndrome
.It is also called HMD. It is condition of surfactant deficiency and physiologic
immaturity of thorax.
Presence of at least 2 of the 3 feature is essential.
Tachypnea
Retraction
Expiratory grunt
It may be associated with multifetal pregnancies,
infants of diabetic mothers ,caesarian section,
pre-term delivery , asphyxia etc.
9. . Risk factors
deficient surfactant production
Unequal inflation of alveoli
Increased efforts to keep unstable alveoli open
Pulmonary vascular resistance increases
Hypo perfusion of lungs
Etiopathogenesis
10. Cont. Hypo perfusion of lungs
Right to left shunt
Hypoxemia , hypercapnia ,acidosis
Hyaline membrane formed
Inhibition of gas exchange
Decreased lung compliance
Respiratory distress syndrome
11. Clinical manifestations
Tachypnea
Tachycardia
Chest wall Retractions
Fine crackles
Expiratory grunting
Nasal flaring
Central cyanosis
Ventilator failure (rising CO2 in the blood)
Extremities puffy or swollen
apnea
14. Diagnostic evaluation
Laboratory findings include an arterial pco2 above 65mmof Hg
and a pH of 7.15 .
The foam stability or shake test is done .
Radiographic examination of chest shows areas of atelectasis .
Prenatal Diagnosis
History of premature delivery
Concentration of lecithin in amniotic fluids.
Ratio of lecithin/sphingomyelin
Lecithin indicate lung maturity
Sphingomyelin remains constant during
pregnancy
L/S ratio 2:1 indicate lung maturity
15. low lung volume and the classic diffuse reticulogranular
ground-glass appearance
17. Cont.
Assessment of severity of the respiratory Distress in
two methods
Paramet
er
0 1 2
RR(per
min)
<60 60-80 >80
Cynosis Absent In room
air
In
40%O2
Grunt Absent Audible
with a
Stethosc
ope
Audible
with a
nacked
ear
Retracti
on
Absent Mild Moderat
e –sever
Air
entry
Good Diminis
hed
Barely
Audible
Sign
s
0 1 2
Upper Chest Sync
hroni
zed
Lags
on
inspi
ratio
n
See
saw
respi
ratio
n
Lower Chest No
retra
ction
Just
visibl
e
Mark
ed
Xiphoid
Retraction
None Just
visibl
e
Mark
ed
Nares
dilatation
None Mini
mal
Mark
ed
Expiratory
Grunt
None Steth
osco
pe
only
Nake
d ear
A. Downe’score B. Silverman –Anderson score
•A score of >6 indicates impending respiratory failure and warrants mechanical
ventilation
19. THERAPEUTIC MANAGEMENT
OXYGEN THERAPY
Indications
1. Clinical central cyanosis
2. Hypoxemia (O2 saturation<87% and
PaO2<50mmHg in room air )
1. Neonates suspected RDS.
Commonly used O2 delivery system in neonates:-
Low flow system are commonly used in neonate. These
system provide a variable FiO2 depending upon the inspiratory
flow rate generate by the neonate.
20. Cont.
Precaution while administering O2 :-
i. humidify
ii. O2 saturation should never cross 93% in preterm infant as –
hyperoxia leads
iii. Use O2 analyzer to check FiO2
following way of oxygen therapy-
i. CPAP(continuous positive airway pressure)
ii. PEEP(positive end-expiratory pressure)
iii. SIMV(synchronized intermittent mandatory ventilation)
iv. HFV (high frequency ventilation)
21. Cont.
SURFACTANT THERAPY
Indications:-
Prophylactic:-preterm infants of <28wks gestation.
Administered within the initial 15-20min of life.
Early rescue:-Administration is typical within the initial 2 hr
of life.
Late rescue:- Administration is typical within the beyond24
hr of life.
23. Cont.
Medical therapy
• Maintenance of I/V line for hydration & nutrition
• Systemic antibiotics if sepsis
• Morphine, Lorazepam for pain & sedation
• Methylxanthines (Theophylline) for apnea
• VLBW & LBW needs mechanical ventilation
• Inotropes (dopamine & dobutamine) to support BP
• Blood transfusion / Erythropoitin therapy
24. .
Nitric oxide therapy
For relieving, persistent pulmonary hypertension, pulmonary
vasoconstriction, subsequent acidosis, severe hypoxia. NO
reduces pulmonary vasoconstriction & subsequent pulmonary
hypertension when inhaled into lungs (6-20ppm)
Prevention
prevention of premature delivery especially in elective early
delivery (ELSCS)
Improved amniocentesis methods for assessing the maturity of
fetal lung,
administration of corticosteroid to induce surfactant production
(24 hours to 7 days before delivery).
25. Cont.
Prophylactic surfactant therapy is not recommended
in infant greater than 30 weeks gestation
Delaying premature birth. Tocolytics may delay
delivery by 48 hours and therefore enable time for
antenatal corticosteroids to be given.
Good control of maternal diabetes
Avoid hypothermia in the neonate
26. NURSING MANAGEMENT
Nursing diagnosis
1 Impaired Gas Exchange related to decreased volumes and
lung compliance, pulmonary perfusion and alveolar ventilation.
2. Potential risk for hypothermia development related to
prematurity
3. Potential risk for infection due to prematurity, low immunity
& invasive procedure
4. Imbalance Nutrition Less Than Body Requirements related
to the inability to suck decreased intestinal motility.
NURSING CARE PLAN RDS.docx
27. Diagnosis
1.Impaired Gas Exchange related to decreased volumes
and lung compliance, pulmonary perfusion and alveolar
ventilation.
Intervention:-
Monitor dyspnea, tachypnea, breath sounds, increased
respiratory effort, lung expansion, and weakness.
Oxygen delivery in accordance with the additional requirements.
Monitor vital signs. (T,P,R,B/P)
See that the prongs are placed properly in the nostril of the baby
See whether the prongs are of the size of the baby
Do not ignore any alarm of the ventilator attached to the baby
28. 2. Potential risk for hypothermia
development related to prematurity
Intervention:-
Care of the baby under radiant warmer
Set the temperature of warmer accurately
Fix the temperature probe to the baby’s abdomen
properly
Check the baby’s temperature 2hrly with thermometer.
Prepare injections under the laminar air flow (UV
light) using proper aseptic technique
Clean the I/V site & change plaster when soiled
29. 3. Potential risk for infection due to prematurity,
low immunity & invasive procedure
Intervention:-
Wear sterile gown & chapels & wash hands before
entering NICU
Wash hands thoroughly with soap & water & apply
sterlium before & after touching the Baby
Ensure the baby is getting adequate feed
Do place a thin plastic wrap on the cot of baby
Maintain documentation
30. 4. Imbalance Nutrition Less Than Body
Requirements related to the inability to suck decreased
intestinal motility.
Implementation
Facilitate rooming in.
Allow mother to have good access to the baby
Allow mother to touch & hold the baby
Wash hands before preparing feeds
Prepare feeds as suggested
Teach the mother the manual expression of breast milk
Give feeds with katori & spoon
Weigh the baby daily
Maintain intake output
31. NURSING CARE
Nursing management with surfactant administration are-
1. Assistance in delivery of product.
2. Monitoring ABG and infants tolerance of procedure.
3. Monitoring oxygenation.
4. Delaying suctioning.
Providing effective ventilation.
Providing optimal enviromental temperature.
32. Cont.
Adequate nutrition .
Effective ventilation and oxygen therapy .
Acid base balance.
Normal hematocrit and blood pressure.
Additional nursing management includes –
1. head elevation and hyperextension.
2. skin irritation from oxygen tubings.
3. Minimal handing.
33. summarization
Introduction
Definition
Etiopathogenesis
Clinical manifestation
Diagnostic evaluation
Assessment of severity of the respiratory Distress in two
methods
Therapeutic management
34. References.
Whaley & Wong’s, Nursing care of infant & children, fifth edition,
page 396-405
Hockenberry, Wong’s Nursing Care of Infant & Children, eighth
edition, page;379-
Dutta D C, textbook of Obstetric, Page: 194-98
www.google//https://respiratory.distress.syndrome.in.com
national neonatology forum of india. National neonal perinatal
databse-report for 2002-03,
international organization for standardization. Respiratory tract
humidifier for medical use ,particular requirement for
humidification system.ISO 8185-07
