(VERSION A, TEST SCORE 94%) RESP 3320 - UNIT 1
Neonatal & Pediatric Respiratory Disorders
RDS - Respiratory Distress Syndrome (premies)
TTN - Transient tachypnea of the newborn
What are the lung parenchymal diseases?
MAS - Meconium aspiration syndrome
BPD - Bronchopulmonary dysplasia (premies)
- SIDS
- GERD
What are the pediatric - Bronchiolitis
respiratory disorders? - Croup
- Epiglottitis
- CF
- Lung parenchyma diseases
- Control of breathing (AOP)
What are ALL the types of Neonatal & - Pulmonary vascular disease (PPHN)
Pediatric Respiratory Disorders? - Congenital abnormalities affecting respiration
- Congenital heart disease
- Pediatric respiratory disorders
Whats another name for RDS (respiratory Hyaline membrane disease
distress syndrome)?
What does surfactant production depend Lung maturity
on? Adequate fetal perfusion
- Surfactant deficiency (quality)
What are the major factors that contribute - Decreased alveolar surface area
to RDS? - Increased small airway compliance
- Presence of ductus arteriosus
, - Placental abruption
- Maternal diabetes
What maternal factors impair blood flow to
- Multiple births
the fetus and can result in RDS?
- Precipitous delivery (unintended delivery of infant)
- Cold stress
What happens when surfactant is RDS
produced but is trapped in type 2 cells? (Ineffective surfactant)
- Failure to decrease surface tension in alveoli
- Collapse of alveoli
- Increased WOB
Ineffective surfactant can result in... - Capillary fluid drawn into the alveoli
- Gas exchange impairment
- Hypoxemia and acidosis (asphyxia)
- Increase in PVR
- Diffuse, hazy reticulogranular densities
How is RDS definitively diagnosed by
- Air bronchograms
chest X-ray?
- Low lung volumes
- CPAP (mask or nasal prongs @ 5-7 cmH2O)
- Mechanical Ventilation (if oxygenation doesnt improve w CPAP or PT is
What are the treatments for RDS? apneic/cyanotic)
- Surfactant replacement therapy (SRT)
- High frequency ventilation
- Prophylactic (low birthweight, less than 1500g; given 30 min of birth)
What are the 2 surfactant administration - Rescue therapy (when intubation is required due to increased WOB &
classifications? O2 requirements, given within 12hr after birth)
*both delivered directly into trachea
- Survanta (beractant), natural bovine extract
What are the SRT (surfactant replacement - Infasurf (calfactant), natural bovine extract
therapy) preparations used in the US? - Curosurf (Poractant alfa), natural porcine extract
- Surfaxin (lucinactant), 1st non animal derived
What is the dosage for survanta 4 ml/kg q 6-12 hrs (max: 4 doses in 48hrs)
(beractant)?
What is the dosage for Infasurf 3 ml/kg q 12hrs (max: 3 doses)
(calfactant)?
What is the dosage for Curosurf (Poractant 1.25-2.5 ml/kg q 12hrs (max: 4 doses)
alfa)?
What is the dosage for Surfaxin 5.8 ml/kg q 6 hrs (max: 4 doses in 48hrs)
(lucinactant)?
TTN (transient tachypnea of the newborn)
What is type 2 RDS?
MOST COMMON RESPIRATORY DISORDER OF THE NEWBOWN
What are the most likely causes or Thought to be related to retained fetal lung fluid
conditions that can lead to TTN? - born term to mom's w/ prolonged labor and failure to progress, C-Section
- Rapid breathing during first hrs after birth
- pH and PaCO2 usually normal
What are the clinical manifestations of TTN X-ray:
(transient tachypnea of the newborn)? - hyperinflation (airtrapping)
- Perihilar streaking (lymphatic engorgement)
- Pleural effusions may be present (costophrenic angle and/or interlobar fissures)
Neonatal & Pediatric Respiratory Disorders
RDS - Respiratory Distress Syndrome (premies)
TTN - Transient tachypnea of the newborn
What are the lung parenchymal diseases?
MAS - Meconium aspiration syndrome
BPD - Bronchopulmonary dysplasia (premies)
- SIDS
- GERD
What are the pediatric - Bronchiolitis
respiratory disorders? - Croup
- Epiglottitis
- CF
- Lung parenchyma diseases
- Control of breathing (AOP)
What are ALL the types of Neonatal & - Pulmonary vascular disease (PPHN)
Pediatric Respiratory Disorders? - Congenital abnormalities affecting respiration
- Congenital heart disease
- Pediatric respiratory disorders
Whats another name for RDS (respiratory Hyaline membrane disease
distress syndrome)?
What does surfactant production depend Lung maturity
on? Adequate fetal perfusion
- Surfactant deficiency (quality)
What are the major factors that contribute - Decreased alveolar surface area
to RDS? - Increased small airway compliance
- Presence of ductus arteriosus
, - Placental abruption
- Maternal diabetes
What maternal factors impair blood flow to
- Multiple births
the fetus and can result in RDS?
- Precipitous delivery (unintended delivery of infant)
- Cold stress
What happens when surfactant is RDS
produced but is trapped in type 2 cells? (Ineffective surfactant)
- Failure to decrease surface tension in alveoli
- Collapse of alveoli
- Increased WOB
Ineffective surfactant can result in... - Capillary fluid drawn into the alveoli
- Gas exchange impairment
- Hypoxemia and acidosis (asphyxia)
- Increase in PVR
- Diffuse, hazy reticulogranular densities
How is RDS definitively diagnosed by
- Air bronchograms
chest X-ray?
- Low lung volumes
- CPAP (mask or nasal prongs @ 5-7 cmH2O)
- Mechanical Ventilation (if oxygenation doesnt improve w CPAP or PT is
What are the treatments for RDS? apneic/cyanotic)
- Surfactant replacement therapy (SRT)
- High frequency ventilation
- Prophylactic (low birthweight, less than 1500g; given 30 min of birth)
What are the 2 surfactant administration - Rescue therapy (when intubation is required due to increased WOB &
classifications? O2 requirements, given within 12hr after birth)
*both delivered directly into trachea
- Survanta (beractant), natural bovine extract
What are the SRT (surfactant replacement - Infasurf (calfactant), natural bovine extract
therapy) preparations used in the US? - Curosurf (Poractant alfa), natural porcine extract
- Surfaxin (lucinactant), 1st non animal derived
What is the dosage for survanta 4 ml/kg q 6-12 hrs (max: 4 doses in 48hrs)
(beractant)?
What is the dosage for Infasurf 3 ml/kg q 12hrs (max: 3 doses)
(calfactant)?
What is the dosage for Curosurf (Poractant 1.25-2.5 ml/kg q 12hrs (max: 4 doses)
alfa)?
What is the dosage for Surfaxin 5.8 ml/kg q 6 hrs (max: 4 doses in 48hrs)
(lucinactant)?
TTN (transient tachypnea of the newborn)
What is type 2 RDS?
MOST COMMON RESPIRATORY DISORDER OF THE NEWBOWN
What are the most likely causes or Thought to be related to retained fetal lung fluid
conditions that can lead to TTN? - born term to mom's w/ prolonged labor and failure to progress, C-Section
- Rapid breathing during first hrs after birth
- pH and PaCO2 usually normal
What are the clinical manifestations of TTN X-ray:
(transient tachypnea of the newborn)? - hyperinflation (airtrapping)
- Perihilar streaking (lymphatic engorgement)
- Pleural effusions may be present (costophrenic angle and/or interlobar fissures)
