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.
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.
The document discusses respiratory distress in neonates. It describes the clinical presentation of respiratory distress and various scoring systems used to assess severity. It then covers the major causes of respiratory distress including transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia and others. For each cause, it discusses risk factors, clinical features, investigations and management. The management sections provide details on oxygen therapy, CPAP, surfactant administration and mechanical ventilation.
Meconium aspiration syndrome (MAS) occurs when an infant aspirates meconium during delivery or birth, leading to respiratory distress. Risk factors include post-term pregnancy or conditions that cause fetal stress. Affected infants experience respiratory distress, often requiring oxygen therapy, CPAP, or mechanical ventilation. Complications can include air leaks, pulmonary hypertension, or long-term lung issues. Treatment focuses on clearing meconium from the airways, managing respiratory support and oxygen needs, and treating complications like infections or pulmonary hypertension. Prevention strategies center on monitoring high risk pregnancies and potentially inducing labor or performing C-sections before complications arise.
Bronchopulmonary dysplasia is a pathologic process leading to signs and symptoms of chronic lung disease that originates in the neonatal period.
Presented by Dr. Tahir
This document discusses respiratory distress syndrome (RDS), also known as hyaline membrane disease (HMD). RDS is caused by surfactant deficiency in preterm infants and affects lung development and function. Key points include:
- RDS incidence is inversely related to gestational age and birth weight, peaking at 24-48 hours of life.
- Surfactant deficiency leads to atelectasis, decreased lung compliance, increased work of breathing and hypoxemia.
- Surfactant is normally produced by type II alveolar cells starting around 24 weeks gestation and is essential for reducing surface tension in the lungs.
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
Bronchopulmonary dysplasia (BPD) is a lung disease that primarily affects extremely premature infants. The most severe cases occur in babies born between 23-26 weeks gestation. While corticosteroids and diuretics can provide short-term improvement for ventilator-dependent infants, there are safety concerns about steroid use. When transitioning infants with BPD from the neonatal intensive care unit to other facilities, it can be difficult for parents to adjust to new practices and staff. Oxygen management also varies, as there is no consensus on optimal weaning.
This document discusses rational surfactant therapy. It begins by establishing that surfactant replacement therapy works based on multiple randomized controlled trials showing reductions in mortality, duration of ventilation and hospital stay. It describes the types of surfactants available and recommends natural surfactants. The document discusses the timing of surfactant replacement, benefits of multiple doses, and synergistic effects with antenatal steroids. Ventilatory management after surfactant including INSURE technique is covered, along with risks of the therapy.
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.
The document discusses respiratory distress in neonates. It describes the clinical presentation of respiratory distress and various scoring systems used to assess severity. It then covers the major causes of respiratory distress including transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia and others. For each cause, it discusses risk factors, clinical features, investigations and management. The management sections provide details on oxygen therapy, CPAP, surfactant administration and mechanical ventilation.
Meconium aspiration syndrome (MAS) occurs when an infant aspirates meconium during delivery or birth, leading to respiratory distress. Risk factors include post-term pregnancy or conditions that cause fetal stress. Affected infants experience respiratory distress, often requiring oxygen therapy, CPAP, or mechanical ventilation. Complications can include air leaks, pulmonary hypertension, or long-term lung issues. Treatment focuses on clearing meconium from the airways, managing respiratory support and oxygen needs, and treating complications like infections or pulmonary hypertension. Prevention strategies center on monitoring high risk pregnancies and potentially inducing labor or performing C-sections before complications arise.
Bronchopulmonary dysplasia is a pathologic process leading to signs and symptoms of chronic lung disease that originates in the neonatal period.
Presented by Dr. Tahir
This document discusses respiratory distress syndrome (RDS), also known as hyaline membrane disease (HMD). RDS is caused by surfactant deficiency in preterm infants and affects lung development and function. Key points include:
- RDS incidence is inversely related to gestational age and birth weight, peaking at 24-48 hours of life.
- Surfactant deficiency leads to atelectasis, decreased lung compliance, increased work of breathing and hypoxemia.
- Surfactant is normally produced by type II alveolar cells starting around 24 weeks gestation and is essential for reducing surface tension in the lungs.
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
Bronchopulmonary dysplasia (BPD) is a lung disease that primarily affects extremely premature infants. The most severe cases occur in babies born between 23-26 weeks gestation. While corticosteroids and diuretics can provide short-term improvement for ventilator-dependent infants, there are safety concerns about steroid use. When transitioning infants with BPD from the neonatal intensive care unit to other facilities, it can be difficult for parents to adjust to new practices and staff. Oxygen management also varies, as there is no consensus on optimal weaning.
This document discusses rational surfactant therapy. It begins by establishing that surfactant replacement therapy works based on multiple randomized controlled trials showing reductions in mortality, duration of ventilation and hospital stay. It describes the types of surfactants available and recommends natural surfactants. The document discusses the timing of surfactant replacement, benefits of multiple doses, and synergistic effects with antenatal steroids. Ventilatory management after surfactant including INSURE technique is covered, along with risks of the therapy.
This document discusses respiratory distress syndrome (RDS) in newborns, including its definition, incidence, clinical causes, pathophysiology, clinical manifestations, diagnostic evaluations, preventive measures, complications, treatment principles, and nursing care. RDS occurs in preterm infants due to deficient surfactant production and presents as respiratory distress within hours of birth. Diagnosis is based on clinical signs and confirmed with tests like chest x-rays. Treatment involves supportive care in the NICU, surfactant replacement therapy, and careful monitoring to prevent complications.
Persistent pulmonary hypertension of newborn PPHNChandan Gowda
Persistent pulmonary hypertension of the newborn (PPHN) results from failure of the normal decrease in pulmonary vascular resistance after birth, causing right-to-left shunting of blood and hypoxemia. It can be caused by underdevelopment, maldevelopment, or maladaptation of the pulmonary vasculature. Clinical features include cyanosis and respiratory distress within the first 24 hours of life. Diagnosis involves echocardiography demonstrating elevated pulmonary pressures and responding poorly to oxygen challenges. Treatment aims to reduce PVR through ventilation strategies, medications, and potentially extracorporeal membrane oxygenation.
This document discusses neonatal mechanical ventilation. It begins by introducing mechanical ventilation and its importance in improving neonatal survival since the 1960s. It then discusses the benefits of mechanical ventilation in improving gas exchange and decreasing work of breathing. Various indications for ventilation are provided. Common conditions requiring ventilation are also listed. The document goes on to describe different types of ventilators and modes, how to initiate a breath, and studies comparing different modes. It concludes by discussing parameters for conventional ventilation like PIP, PEEP, flow rates, and methods for controlling oxygenation and ventilation.
Meconium aspiration syndrome is a respiratory distress in infants born through meconium-stained amniotic fluid. Risk factors include maternal health problems, post-term pregnancy, and fetal stress. Meconium obstructs airways, causes chemical pneumonitis, and inactivates surfactant. Affected infants have respiratory distress, and chest X-rays show hyperinflated lungs. Management includes suctioning meconium during delivery, pulmonary toilet, oxygen therapy, ventilation if needed, antibiotics, and treatments for pulmonary hypertension. Complications are common and outcomes range from full recovery to long-term issues like cerebral palsy.
Surfactant therapy |medical administration of exogenous surfactantNEHA MALIK
Surfactant therapy is the medical administration of exogenous surfactant. Surfactants used in this manner are typically instilled directly into the trachea. When a baby comes out of the womb and the lungs are not developed yet, they require administration of surfactant in order to process oxygen and survive.
Bronchopulmonary dysplasia updates_and_prevention dr falakhagfalakha
The document discusses bronchopulmonary dysplasia (BPD) and strategies for prevention. It notes that BPD results from disrupted alveolar development and remodeling of the airways, vasculature, and smooth muscle. Risk factors include prematurity, genetics, chorioamnionitis, and exposures associated with resuscitation and mechanical ventilation. Strategies discussed to prevent BPD include using lower oxygen concentrations during resuscitation, applying continuous positive airway pressure, and avoiding overinflation and atelectrauma through gentle ventilation techniques. Future research is still needed to develop more evidence-based prevention and treatment approaches for BPD.
This document discusses bronchopulmonary dysplasia (BPD), a chronic lung disease that occurs in premature infants requiring respiratory support. It covers the definition, risk factors, pathogenesis, clinical features, prevention, and treatment of BPD. The definition has evolved over time from relying solely on oxygen need at 28 days to incorporating factors like oxygen need, pressure support, and gestational age. BPD results from lung injury and disrupted lung development due to prematurity and respiratory support. Management aims to protect the lung from injury through gentle ventilation, optimal oxygen levels, and other strategies.
This document provides information on respiratory distress syndrome (RDS), including its definition, etiology, pathophysiology, signs and symptoms, investigations, management, nursing diagnoses, and nursing interventions. RDS is a disease in newborns related to deficiency of surfactant in the lungs, leading to respiratory distress. Key factors that can decrease surfactant and contribute to RDS include prematurity, hypothermia, asphyxia, and having a diabetic mother. Management involves supportive care like oxygen supplementation and ventilation support if needed, as well as more aggressive treatments like surfactant replacement therapy for very preterm infants.
Respiratory distress syndrome (RDS), also known as hyaline membrane disease (HMD), is an acute lung disease in newborns caused by pulmonary surfactant deficiency, which tends to occur in preterm infants younger than 32 weeks gestational age. The incidence increases with lower gestational age and higher rates are seen in infants of diabetic mothers. Treatment involves oxygen therapy, ventilation support, and replacement of pulmonary surfactant to reduce mortality and complications like pneumothorax. Prevention strategies include antenatal corticosteroid therapy and prophylactic surfactant treatment.
This document discusses various causes of respiratory distress in newborns, including transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and neonatal pneumonia. It provides details on the signs and symptoms, risk factors, diagnosis, and management of each condition. For TTN, it notes the risk factors include premature birth or c-section without labor. For RDS, it explains that surfactant deficiency in preterm infants is the primary cause. For neonatal pneumonia, it identifies the most common causative organisms and states diagnosis is based on clinical, radiographic, and microbiological findings.
Meconium aspiration syndrome (MAS) occurs when meconium, the first intestinal discharge of newborns, is breathed into the lungs before or during birth. It can cause respiratory distress in newborns. The document defines MAS and discusses the incidence, causes, pathophysiology, clinical features, diagnosis, prevention, management, complications, and prognosis of the condition. MAS is managed through supportive care in the neonatal ICU including respiratory support, antibiotics, and surfactant therapy. The prognosis depends on the severity of symptoms and associated complications such as brain damage or persistent pulmonary hypertension.
This document discusses apnea of prematurity, defined as the cessation of breathing for over 20 seconds or less than 20 seconds accompanied by hypoxia or bradycardia in premature infants. It classifies apnea as central, obstructive, or mixed. Risk increases inversely with gestational age. Causes include immaturity of the brainstem respiratory center and exaggerated laryngeal reflex. Clinical presentation involves monitoring for apnea, bradycardia, and desaturation. Diagnosis is made using cardiorespiratory monitoring and pulse oximetry.
Respiratory distress is a common problem in newborns. This document discusses the epidemiology, clinical features, assessment, causes and management approaches for several major causes of respiratory distress in newborns, including meconium aspiration syndrome, respiratory distress syndrome, and transient tachypnea of newborn. It provides clinical guidance on evaluating and treating newborns presenting with respiratory distress.
Respiratory Distress Syndrome (RDS) is a condition seen primarily in premature infants caused by a lack of pulmonary surfactant. This deficiency leads to alveolar collapse and respiratory failure. The risk of developing RDS increases the younger the gestational age. Clinical presentation includes tachypnea, retractions, and hypoxemia. Diagnosis is made based on clinical features and chest x-ray showing diffuse lung opacities. Treatment focuses on supportive care including oxygen therapy and mechanical ventilation. Surfactant replacement therapy is also used to reduce mortality from RDS.
This document provides an outline for a presentation on bronchopulmonary dysplasia (BPD). It begins with an introduction defining BPD and its increasing prevalence in preterm infants. The outline then covers the definition, epidemiology, risk factors including prematurity, lung injury from mechanical ventilation and oxygen toxicity, pathophysiology involving disrupted lung development, clinical presentation with respiratory symptoms, and management approaches to prevent and treat BPD.
This document discusses bronchopulmonary dysplasia (BPD), including its definition, incidence, pathogenesis, clinical features, radiographic appearance, and clinical course. BPD was originally defined based on oxygen need at 28 days of age in premature infants, but definitions have evolved. Incidence increases with lower birth weight. Pathogenesis is multifactorial, involving prematurity, mechanical ventilation, oxygen toxicity, infection, inflammation, and genetic factors. Clinical features include tachypnea, retractions, and hypoxemia. Chest x-rays may show haziness, atelectasis, or hyperinflation. The clinical course ranges from improvement over months to severe illness requiring prolonged support.
This document discusses persistent pulmonary hypertension of the newborn (PPHN) with a focus on management in resource-limited settings. It provides background on PPHN, including associated conditions, signs and symptoms, diagnostic testing, and supportive care strategies. Key interventions discussed include inhaled nitric oxide (iNO), high frequency ventilation (HFV), and sildenafil. While iNO and HFV are standard treatments, their high costs limit use in many resource-poor areas. The document explores using less expensive options like sildenafil and discusses how HFV could potentially be utilized more in Nepal with appropriate equipment, training, and support.
This document discusses various pulmonary causes of peripartum hypoxia including both chronic and acute conditions. Chronic causes mentioned include pneumonia, bronchial asthma, tuberculosis, and interstitial lung diseases. Acute causes discussed in more detail include venous thromboembolism, aspiration pneumonia, amniotic fluid embolism, ARDS, pulmonary edema, anesthetic complications, and pneumothorax. For each condition, the document outlines signs and symptoms, diagnostic criteria, and recommended treatment approaches.
This document discusses several common respiratory diseases that can affect newborns, including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), primary pulmonary hypertension of the newborn (PPHN), and apnea of prematurity. It provides details on the causes, clinical presentations, diagnoses and management of each condition. The document is intended to educate medical professionals such as pediatricians on recognizing and treating respiratory issues in newborns.
This document discusses respiratory distress syndrome (RDS) in newborns, including its definition, incidence, clinical causes, pathophysiology, clinical manifestations, diagnostic evaluations, preventive measures, complications, treatment principles, and nursing care. RDS occurs in preterm infants due to deficient surfactant production and presents as respiratory distress within hours of birth. Diagnosis is based on clinical signs and confirmed with tests like chest x-rays. Treatment involves supportive care in the NICU, surfactant replacement therapy, and careful monitoring to prevent complications.
Persistent pulmonary hypertension of newborn PPHNChandan Gowda
Persistent pulmonary hypertension of the newborn (PPHN) results from failure of the normal decrease in pulmonary vascular resistance after birth, causing right-to-left shunting of blood and hypoxemia. It can be caused by underdevelopment, maldevelopment, or maladaptation of the pulmonary vasculature. Clinical features include cyanosis and respiratory distress within the first 24 hours of life. Diagnosis involves echocardiography demonstrating elevated pulmonary pressures and responding poorly to oxygen challenges. Treatment aims to reduce PVR through ventilation strategies, medications, and potentially extracorporeal membrane oxygenation.
This document discusses neonatal mechanical ventilation. It begins by introducing mechanical ventilation and its importance in improving neonatal survival since the 1960s. It then discusses the benefits of mechanical ventilation in improving gas exchange and decreasing work of breathing. Various indications for ventilation are provided. Common conditions requiring ventilation are also listed. The document goes on to describe different types of ventilators and modes, how to initiate a breath, and studies comparing different modes. It concludes by discussing parameters for conventional ventilation like PIP, PEEP, flow rates, and methods for controlling oxygenation and ventilation.
Meconium aspiration syndrome is a respiratory distress in infants born through meconium-stained amniotic fluid. Risk factors include maternal health problems, post-term pregnancy, and fetal stress. Meconium obstructs airways, causes chemical pneumonitis, and inactivates surfactant. Affected infants have respiratory distress, and chest X-rays show hyperinflated lungs. Management includes suctioning meconium during delivery, pulmonary toilet, oxygen therapy, ventilation if needed, antibiotics, and treatments for pulmonary hypertension. Complications are common and outcomes range from full recovery to long-term issues like cerebral palsy.
Surfactant therapy |medical administration of exogenous surfactantNEHA MALIK
Surfactant therapy is the medical administration of exogenous surfactant. Surfactants used in this manner are typically instilled directly into the trachea. When a baby comes out of the womb and the lungs are not developed yet, they require administration of surfactant in order to process oxygen and survive.
Bronchopulmonary dysplasia updates_and_prevention dr falakhagfalakha
The document discusses bronchopulmonary dysplasia (BPD) and strategies for prevention. It notes that BPD results from disrupted alveolar development and remodeling of the airways, vasculature, and smooth muscle. Risk factors include prematurity, genetics, chorioamnionitis, and exposures associated with resuscitation and mechanical ventilation. Strategies discussed to prevent BPD include using lower oxygen concentrations during resuscitation, applying continuous positive airway pressure, and avoiding overinflation and atelectrauma through gentle ventilation techniques. Future research is still needed to develop more evidence-based prevention and treatment approaches for BPD.
This document discusses bronchopulmonary dysplasia (BPD), a chronic lung disease that occurs in premature infants requiring respiratory support. It covers the definition, risk factors, pathogenesis, clinical features, prevention, and treatment of BPD. The definition has evolved over time from relying solely on oxygen need at 28 days to incorporating factors like oxygen need, pressure support, and gestational age. BPD results from lung injury and disrupted lung development due to prematurity and respiratory support. Management aims to protect the lung from injury through gentle ventilation, optimal oxygen levels, and other strategies.
This document provides information on respiratory distress syndrome (RDS), including its definition, etiology, pathophysiology, signs and symptoms, investigations, management, nursing diagnoses, and nursing interventions. RDS is a disease in newborns related to deficiency of surfactant in the lungs, leading to respiratory distress. Key factors that can decrease surfactant and contribute to RDS include prematurity, hypothermia, asphyxia, and having a diabetic mother. Management involves supportive care like oxygen supplementation and ventilation support if needed, as well as more aggressive treatments like surfactant replacement therapy for very preterm infants.
Respiratory distress syndrome (RDS), also known as hyaline membrane disease (HMD), is an acute lung disease in newborns caused by pulmonary surfactant deficiency, which tends to occur in preterm infants younger than 32 weeks gestational age. The incidence increases with lower gestational age and higher rates are seen in infants of diabetic mothers. Treatment involves oxygen therapy, ventilation support, and replacement of pulmonary surfactant to reduce mortality and complications like pneumothorax. Prevention strategies include antenatal corticosteroid therapy and prophylactic surfactant treatment.
This document discusses various causes of respiratory distress in newborns, including transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and neonatal pneumonia. It provides details on the signs and symptoms, risk factors, diagnosis, and management of each condition. For TTN, it notes the risk factors include premature birth or c-section without labor. For RDS, it explains that surfactant deficiency in preterm infants is the primary cause. For neonatal pneumonia, it identifies the most common causative organisms and states diagnosis is based on clinical, radiographic, and microbiological findings.
Meconium aspiration syndrome (MAS) occurs when meconium, the first intestinal discharge of newborns, is breathed into the lungs before or during birth. It can cause respiratory distress in newborns. The document defines MAS and discusses the incidence, causes, pathophysiology, clinical features, diagnosis, prevention, management, complications, and prognosis of the condition. MAS is managed through supportive care in the neonatal ICU including respiratory support, antibiotics, and surfactant therapy. The prognosis depends on the severity of symptoms and associated complications such as brain damage or persistent pulmonary hypertension.
This document discusses apnea of prematurity, defined as the cessation of breathing for over 20 seconds or less than 20 seconds accompanied by hypoxia or bradycardia in premature infants. It classifies apnea as central, obstructive, or mixed. Risk increases inversely with gestational age. Causes include immaturity of the brainstem respiratory center and exaggerated laryngeal reflex. Clinical presentation involves monitoring for apnea, bradycardia, and desaturation. Diagnosis is made using cardiorespiratory monitoring and pulse oximetry.
Respiratory distress is a common problem in newborns. This document discusses the epidemiology, clinical features, assessment, causes and management approaches for several major causes of respiratory distress in newborns, including meconium aspiration syndrome, respiratory distress syndrome, and transient tachypnea of newborn. It provides clinical guidance on evaluating and treating newborns presenting with respiratory distress.
Respiratory Distress Syndrome (RDS) is a condition seen primarily in premature infants caused by a lack of pulmonary surfactant. This deficiency leads to alveolar collapse and respiratory failure. The risk of developing RDS increases the younger the gestational age. Clinical presentation includes tachypnea, retractions, and hypoxemia. Diagnosis is made based on clinical features and chest x-ray showing diffuse lung opacities. Treatment focuses on supportive care including oxygen therapy and mechanical ventilation. Surfactant replacement therapy is also used to reduce mortality from RDS.
This document provides an outline for a presentation on bronchopulmonary dysplasia (BPD). It begins with an introduction defining BPD and its increasing prevalence in preterm infants. The outline then covers the definition, epidemiology, risk factors including prematurity, lung injury from mechanical ventilation and oxygen toxicity, pathophysiology involving disrupted lung development, clinical presentation with respiratory symptoms, and management approaches to prevent and treat BPD.
This document discusses bronchopulmonary dysplasia (BPD), including its definition, incidence, pathogenesis, clinical features, radiographic appearance, and clinical course. BPD was originally defined based on oxygen need at 28 days of age in premature infants, but definitions have evolved. Incidence increases with lower birth weight. Pathogenesis is multifactorial, involving prematurity, mechanical ventilation, oxygen toxicity, infection, inflammation, and genetic factors. Clinical features include tachypnea, retractions, and hypoxemia. Chest x-rays may show haziness, atelectasis, or hyperinflation. The clinical course ranges from improvement over months to severe illness requiring prolonged support.
This document discusses persistent pulmonary hypertension of the newborn (PPHN) with a focus on management in resource-limited settings. It provides background on PPHN, including associated conditions, signs and symptoms, diagnostic testing, and supportive care strategies. Key interventions discussed include inhaled nitric oxide (iNO), high frequency ventilation (HFV), and sildenafil. While iNO and HFV are standard treatments, their high costs limit use in many resource-poor areas. The document explores using less expensive options like sildenafil and discusses how HFV could potentially be utilized more in Nepal with appropriate equipment, training, and support.
This document discusses various pulmonary causes of peripartum hypoxia including both chronic and acute conditions. Chronic causes mentioned include pneumonia, bronchial asthma, tuberculosis, and interstitial lung diseases. Acute causes discussed in more detail include venous thromboembolism, aspiration pneumonia, amniotic fluid embolism, ARDS, pulmonary edema, anesthetic complications, and pneumothorax. For each condition, the document outlines signs and symptoms, diagnostic criteria, and recommended treatment approaches.
This document discusses several common respiratory diseases that can affect newborns, including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), primary pulmonary hypertension of the newborn (PPHN), and apnea of prematurity. It provides details on the causes, clinical presentations, diagnoses and management of each condition. The document is intended to educate medical professionals such as pediatricians on recognizing and treating respiratory issues in newborns.
This document discusses respiratory distress in newborns, listing common medical and surgical causes such as transient tachypnea of the newborn (TTNB), respiratory distress syndrome (RDS), meconium aspiration syndrome, and pneumothorax. It then focuses on the pathophysiology, clinical presentation, diagnosis, and management of TTNB, RDS, and meconium aspiration syndrome. TTNB is usually mild and self-limited, resolving within 3 days with supportive care. RDS is caused by surfactant deficiency and presents with progressive respiratory distress, responding well to surfactant replacement therapy. Meconium aspiration syndrome involves airway obstruction and inflammation from aspirated meconium, often
Drugs can induce a variety of pulmonary diseases through different mechanisms such as hypersensitivity reactions, direct toxicity, and indirect effects. Common presentations include cough, dyspnea, and abnormal chest imaging. Treatment involves identifying the culprit drug, discontinuing its use, and potentially administering corticosteroids. Early diagnosis is important to prevent long term complications like pulmonary fibrosis.
This document discusses common causes of respiratory distress in newborns including transient tachypnea of the newborn, congenital pneumonia, respiratory distress syndrome, meconium aspiration syndrome, and pneumothorax. Signs of respiratory distress like grunting, nasal flaring, and wheezing are described. Causes are then explained in more detail covering presentation, risk factors, diagnostic testing, and management approaches. Other less common etiologies of newborn respiratory distress are also briefly outlined. The importance of obtaining a thorough history for proper evaluation and treatment of the distressed newborn is emphasized.
This document provides an overview of Acute Respiratory Distress Syndrome (ARDS). It discusses the epidemiology, causes, clinical course and features, diagnostic criteria, investigations and management of ARDS. The key points are: ARDS affects approximately 10% of ICU patients annually and has a mortality rate of around 30%; it is caused by direct or indirect lung injury and progresses through exudative, proliferative and fibrotic phases; diagnosis is based on acute onset hypoxemia, bilateral opacities on chest imaging and low oxygen levels; management focuses on treating the underlying cause, lung protective ventilation with low tidal volumes, PEEP and prone positioning if severe. With treatment, most ARDS survivors recover lung function within 6-
This document discusses Acute Respiratory Distress Syndrome (ARDS) and Ventilator Associated Pneumonia (VAP). It defines ARDS as a sudden respiratory failure characterized by hypoxemia and diffuse lung infiltrates. The document outlines the pathophysiology and stages of ARDS. It also discusses predisposing factors, signs and symptoms, diagnosis, and management including oxygen therapy, medications, prone positioning, and ventilation. The document then defines VAP as pneumonia that develops more than 48 hours after intubation. It discusses risks factors for VAP in ICU patients, types of VAP, pathogens involved, diagnosis, treatment, and prevention strategies.
Pneumonia is an inflammatory lung condition caused by infection that can be fatal. It has many types depending on location in the lungs and cause. Risk factors include age, smoking, and medical conditions. Symptoms include cough, fever, and difficulty breathing. Diagnosis involves physical exam, labs, imaging and microbiology tests. Complications can include empyema or lung abscess if not treated with antibiotics, oxygen, breathing exercises, and posture changes.
This document provides an outline on the management of childhood pneumonia. It discusses the epidemiology, noting that pneumonia is a leading cause of death in children under 5 globally. The classification is described based on origin, type of infecting organism, and severity. The clinical features, management, and investigations are outlined. Chest radiography and lung ultrasound are important diagnostic tools. Treatment involves assessing severity and identifying the causative organism. Recurrent pneumonia requires investigating underlying disorders.
Neonatal respiratory diseases can present as respiratory distress in newborns, characterized by tachypnea, grunting, chest wall indrawing, and cyanosis. Common causes include respiratory distress syndrome (lack of surfactant), pneumonia, meconium aspiration syndrome, and congenital diaphragmatic hernia. Respiratory distress syndrome is treated with supportive care like oxygen supplementation or CPAP, and may require mechanical ventilation. Pneumonia is usually treated with antibiotics and oxygen as needed. Meconium aspiration syndrome can cause lung injury and inflammation requiring oxygen, antibiotics, and steroids. Congenital diaphragmatic hernia presents with respiratory distress at birth due to lung compression, and is
Bronchiectasis is a chronic lung disease defined by irreversible dilation of the bronchi. It develops from an initial event that impairs mucociliary clearance, allowing bacteria to colonize and further damage the lungs. The hallmark symptoms are a chronic cough and sputum production lasting months to years. Risk factors include cystic fibrosis, infections, immunodeficiencies, and exposures to toxic substances. Management involves antibiotics, airway clearance techniques, and supplemental oxygen. Severe cases may require surgery.
This document provides information about acute respiratory distress syndrome (ARDS), including its pathophysiology, clinical manifestations, diagnosis, treatment, nursing care, and complications. ARDS is a respiratory failure condition caused by lung injury and results in increased permeability of the alveolar-capillary membrane. It progresses through exudative, proliferative, and fibrotic phases. Treatment involves supportive care, mechanical ventilation, positioning strategies, and managing complications such as nosocomial pneumonia and renal failure.
ARDS is a life-threatening form of respiratory failure characterized by diffuse lung inflammation and damage leading to hypoxemia. It has multiple causes but is commonly due to sepsis, pneumonia, or trauma. The pathology involves damage to the lung epithelium and endothelium, resulting in fluid accumulation in the alveoli. Treatment focuses on lung-protective ventilation with low tidal volumes, moderate levels of PEEP, and consideration of prone positioning. Other strategies include corticosteroids, neuromuscular blockade, and restrictive fluid management. More severe cases may require advanced support such as ECMO.
Type 1 respiratory failure is defined as hypoxemia without hypercapnia, caused by conditions that impair oxygenation like pneumonia. Type 2 involves both hypoxemia and hypercapnia due to inadequate ventilation from issues like COPD.
Pulmonary embolism occurs when a blood clot lodges in the lungs, impairing gas exchange. Risk factors include leg injuries and surgeries. Diffuse alveolar hemorrhage results from widespread damage to small lung vessels, leading to blood in the alveoli. Causes include autoimmune disorders and infections. Pneumonia has multiple causes and presentations depending on patient factors. Proper diagnosis and treatment of underlying conditions are important for managing respiratory failure.
Pneumonia is an inflammation of the lung caused by various microorganisms. It is classified as community-acquired, hospital-acquired, or in immunocompromised patients. Clinical features include fever, cough, chest pain, and difficulty breathing. Diagnosis involves a chest x-ray and cultures. Treatment consists of antibiotics based on culture results and supportive care like oxygen and hydration. Nursing focuses on improving airway clearance and promoting rest. Complications can include continuing symptoms, shock, respiratory failure, or fluid buildup in the lungs.
complications in newborn pediatrics 3.pptArun170190
This document provides information on transient tachypnea of the newborn (TTN), including:
- TTN is a temporary respiratory condition where newborns have difficulty clearing fluid from their lungs after birth, causing fast breathing.
- Risk factors include cesarean delivery without labor. Symptoms include fast breathing and grunting. Chest X-rays can help with diagnosis.
- Treatment focuses on supportive care like oxygen supplementation. TTN typically resolves within 3 days without long-term impacts. While common, it can occasionally require interventions like CPAP. Overall, TTN prognosis is excellent in most newborns.
Respiratory Distress Syndrome (RDS), formerly known as hyaline membrane disease, is a life-threatening lung disorder that results from underdeveloped lungs and insufficient pulmonary surfactant. It occurs most commonly in preterm infants and results in inadequate lung inflation and collapse. Management involves providing warm oxygen supplementation and potentially ventilator support. Surfactant replacement therapy is also used to reduce mortality and complications like bronchopulmonary dysplasia. With appropriate treatment, prognosis is good especially for infants weighing over 1000 grams.
- The patient is a 65-year-old female with a history of asthma, breast cancer, diabetes, and hypertension who presented with shortness of breath, chest pain, and productive cough.
- Physical exam found decreased breath sounds on the left lung and absent breath sounds on the right lower lung. Chest x-ray and CT scan showed a right-sided pleural effusion. Thoracentesis found exudative fluid with malignant cells.
- The patient was diagnosed with Swyer-James-MacLeod syndrome, a rare condition caused by childhood lung infections that results in unilateral hyperlucent lung on imaging. She received chemotherapy and was discharged on home oxygen.
Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases including chronic bronchitis and emphysema that are characterized by persistent airflow limitation. The main causes of COPD are tobacco smoking, exposure to secondhand smoke, and air pollution. Symptoms include cough, sputum production, and shortness of breath. Diagnosis involves assessing symptoms, lung function tests, and chest imaging. Treatment focuses on smoking cessation, medications to relieve symptoms and prevent exacerbations, pulmonary rehabilitation, and managing complications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. • Neonates: Newborn, terminology describes children from birth to 1
month of life.
• The lungs are the last organs to develop intrauterinely,
• in fact, they continue to develop until at least 8 years of age.
• Respiratory disorders are the most frequent cause of admission in
preterm and term infants.
• They often arise due to failure of transition from fetal to extrauterine
environment.
6. INITIAL MANAGEMENT/SUPPORT OF
CHILDREN WITH RESPIRATORY DISTRESS
• Supplementary O2: delivered through a hood or bag/mask
ventilation
• Non-invasive positive pressure ventilation (NIPPV)
• Continuous Positive Airway Pressure (CPAP)
• Mechanical Ventilation
Fluid should be administered to patients whose symptoms do
not resolve despite oxygen support,
7. SUPPLEMENTARY O2
• Oxygen concentration are set PaO2 of 50-70 mmHg and 60-80
in preterm and term infants respectively, any higher will likely
result in retinopathy of prematurity (ROP).
• Warm and Humidified O2 should be given so as to prevent
secretions from cooling, and bronchospasm from cooling.
• Umbilical Artery Catheter or Radial Artery Catheter for
monitoring ABG and blood sampling.
8. CPAP
• CPAP is indicated if patients are unresponsive to supplementary
O2.
• When FiO2 >40% is required to maintain PaO2 at acceptable
levels.
• In patients with disorders of limited duration ( Mild RDS, diffuse
atelectasis)
• Delivers oxygen at 5-7 cm H20, which prevents the alveoli from
collapsing as well as the prevention of atelectasis.
9. MECHANICAL VENTILATION/INTUBATION
• Indicated in neonates less that 1000 gr or <28 weeks of
gestation.
• When other support methods have failed.
• Diameters and marks for endotracheal tubes are:
2.5mm for <1250 gr 7cm for 1 kg
3mm for 1250-2500 gr 8cm for 2 kg
3.5 for >2500gr 9cm for 3 kg
• Ventilators can be set to deliver fixed pressures or volumes:
AC –assist control
IMV –intermittent mandatory ventilation
10. Adjunctive treatment used with
Mechanical Ventilation are:
• Paralytics and sedatives
(midazolam)
• Nitric Oxide
• Weaning (by lowering ventilation
pressure)
Complications of Ventilator usage
may include:
• Pneumothorax
• Asphyxia due to wrong intubation
• BPD
• Ulceration, Erosion etc
12. RESPIRATORY DISTRESS SYNDROME
• Respiratory distress syndrome is primarily caused by lack of
surfactant in the lungs of the neonate. Onset is usually hours
after birth. The risk of developing RDS increases with
decreasing gestational age, i.e(risk is higher in premature
neonates.)
• Maternal risk factors include maternal hypertension, prolonged
rupture of membrane, while maternal corticosteroid usage is a
protective risk factor
• Due to increase surface tension due to surfactant deficiency,
atelectasis occurs, followed by inflammation and pulmonary
edema.
15. TRANSIENT TACHYPNEA OF NEWBORN
• TTN is a result of delayed resorption of fetal lung fluid, it is
mostly seen in infants delivered by caesarean section, and it
may accompany other respiratory disorders such as RDS and
MAS.
• Patients are likely to present with high levels of secretions
• Treatment is mostly supportive, as disease is limited
16. MECONIUM ASPIRATION SYNDROME
• Occurs as a result of fetal distress, which results in passage of meconium within
the uterus and subsequently aspirated, triggering lung injury.
• post-term infants are more at risk because of increased stress factors in uterus
and reduced amniotic fluid, leading to less dilute meconium.
• Mechanisms of injury include:
1. non specific cytokine release
2. airway obstruction
3. surfactant inactivation
4. chemical pneumonia
Comorbidities include PP hypertension, atelectasis, pneumomediastinum,
pneumothorax.
19. MECONIUM ASPIRATION SYNDROME
Treatment:
• Suctioning: as soon as head is delivered; prior to first breath
• Oxygen
• Mechanical Ventilation
• Support treatment with surfactant, antibiotics.
• nitric oxide if PPH developed
20. PERSISTENT PULMONARY HYPERTENSION
occurs due to persistence of pulmonary arteriolar
vasoconstriction, which results in decrease pulmonary blood flow
and R-L shunting.
• It is mostly seen in postterm infants, and associated with MAS.
• Other causes include perinatal asphyxia, premature dustus
arteriosus closure (maternal NSAID usage), polycythemia etc.
• In mothers using NSAIDs prior to birth
Hypertrophy of pulmonary vessels=R-L shunting= systemic
hypoxemia, eventually leads to right heart dilation, RHF…
Severe cyanosis is marked for PPH
21. PERSISTENT PULMONARY HYPERTENSION
DIAGNOSIS
• Presence of cyanosis that does not responding to O2 treatment
(persistent cyanosis)
• Echocardiogram
• X-ray
Dıfferentıal dx: congenital heart disease.
22.
23. PERSISTENT PULMONARY HYPERTENSION
TREATMENT
• O2
• Nitric Oxide
• Sildenafil
• Mechanical Ventilation
• ECMO
• Circulatory support: IV solutions administration
In general, most treatment measures are supportive.
24. NEONATAL PNEUMONIA
• Divided into early and late onset, the latter occurring 7 days
after birth. Early onset pneumonia is part of generalized sepsis
occurring within hours after birth.
• Occurs in infants that require prolonged intubation
• Vertical transmission from mother; Group B streptococcus, E.
coli, klebsiella in early onset pneumonia.
• S. aureus is the most common causative agent in late onset
pneumonia.
• STDs such as chlamydia may also cause pneumonia.
26. BRONCHOPULMONARY DYSPLASIA
Chronic lung disease resulting primarily from prolonged
ventilation, as well as prematurity.
BPD is affected by the following factors:
• Degree of prematurity
• High O2 concentrations
• Infection
• Prolonged ventilation
Other factors may include pulmonary air-leak
syndromes(pulmonary interstitial emphysema), high peak
inspiratory pressures, increased pulmonary pressure and male
sex.
27. BRONCHOPULMONARY DYSPLASIA
Infants with BPD are more vulnerable to inflammatory that result
from mechanical ventilation, which leads to the disruption of
lung development:
• Fewer alveoli
• Larger alveoli
• Thickened interstitium
28. BRONCHOPULMONARY DYSPLASIA
DIAGNOSIS
The initial requirement for the diagnosis of BPD is continuous O2
(>21%) administration for at least 28 days
• X-ray: multicystic appearance as well as exudative fluid.
• Unable to wean from ventilator
32. PULMONARY AIR-LEAK SYNDROME
These are a set of complications that may occur following any
respiratory disorder, leading to air escaping to surrounding
structures. These include:
• Pulmonary interstitial emphysema
• Pneumomediastinum
• Pneumothorax
• Pneumopericardium
• Pneumoperitoneum
• Subcutaneous emphysema
33. CASE #1
• E.B (protocol No: 362116) Male.
Born after 39th gestational week via C/S to a 21 year old mother on
25/12/2018. BW: 2090 gr. Was tranferred to our NICU two days post-
term with respiratory distress, low saturation with suspected pneumonia.
Patient was intubated prior to arrival. He was started on Sildenafil after
a diagnosis of pulmonary hypertension was made. He was
administered dobutamin and dormicum for support and sedation
respectively. He was constantly followed up for suspected congenital heart
disease and pulmonary hypertension.
• On physical examination, he was hypotonic, cyanotic, and intubated,
intercostal and subcostal retractions were present along with tachypnea.
34. • He received cranial and abdominal USG to rule out additional causes
on RD. Echocardiography showed right to left shunting consistent
with pulmonary hypertension. Lung X-ray showed active infiltration
in the lung parenchyma.
• By 5th post-natal day, general condition of patient had worsened: he
was hypotonic, not feeding, lacked spontaneous respiration despite
resolution of intercostal retractions. Despite receiving sildenafil,
vancomycin, meropenem, surfactant, ilioprost as well as other
supportive treatment, patient went into cardiac arrest and
subsequently died despite rescusitation efforts.
• Final diagnosis was: PPH.
35.
36.
37. REFERENCES
• Gallacher, David J., et al. “Common Respiratory Conditions of
the Newborn.” Breathe, vol. 12, no. 1, 2016, pp. 30–42.,
doi:10.1183/20734735.000716. ( 10.1183/20734735.000716
• Porter, Robert S., and Justin L. Kaplan. The Merck Manual of
Diagnosis and Therapy / Robert S. Porter, Editor-in-Chief ;
Justin L. Kaplan, Senior Assistant Editor. Merck Sharp & Dohme
Corp., 2011.
• radiopaedia.com
Editor's Notes
Respiratory symptoms in children are likely to be exacerbated due to the narrow airway compared to adult, thus great care should be taken in managing not just neonates, but also infants. If unresponsive to these initial treatments, Fluid may be required to increase cardiac output, before moving on to bag ventilation of CPAP.
Neonates less that 28 gestational week or <1000 gr are directly intubated so that they can receive surfactant treatment.
AC delivers full breath with each patient inspiration, while IMV sets a number of breaths within a time period with a window to allow the patient to take spontaneous breaths without triggering the ventilator.
Ball valve mechanism*
CPAP could lead to potential pulmonary air leak syndrome, thus close follow up is advised.