Hypoxic ischemic Encephalopathy:
Cerebral brain injury when the brain doesn’t receive enough oxygen or blood flow. may develop
during pregnancy, labor and delivery or in the postnatal period.
Other causes: Septicemia, meningitis, Metabolic: hypoglycemia, hypo/hypernatremia,
Hypomagnesemia, Inborn errors of metabolism, Pyridoxine dependency.
Seizures Blood glucose level & Electrolytes.
Hypotonia Low heart rate.
Weak cry EEG
Organ dysfunction MRI
Hypotension can be an early sign of shock in adults, but not for children.
Respiratory tract:
• The upper respiratory tract:
nose and nasal passages, paranasal sinuses, the pharynx, and the portion of
the larynx above the vocal folds (cords).
Infections: Coryza, sore throat, earache, sinusitis, stridor.
• The lower respiratory tract:
• the larynx below the vocal folds, trachea, bronchi, bronchioles and alveoli.
• Infections: Bronchitis, bronchiolitis, & pneumonia
• Cough, wheeze, & respiratory distress.
Respiratory distress syndrome:
• RDS (hyaline membrane disease): commonest respiratory disorder in preterm babies &
leading cause of death.
• Caused by developmental insufficiency of surfactant leading to alveolar collapse ‐> V/Q
mismatch ‐> hypoxemia.
Complications:
Acute: Acidosis, air leaks, hypoglycemia, Chronic: ICH, pulmonary hemorrhage,
hypotension, atelectasis, infection, respiratory bronchopulmonary dysplasia, mental
failure & death. impairment.
, BPD (Bronchopulmonary dysplasia) or CLD (chronic lung disease) are most common in premature
babies or LBW babies who received prolonged mechanical ventilation to treat RDS.
In the last 3 decades, improvement of outcomes in RDS due to:
• Introduction of antenatal steroids. (2 doses, 12 hr apart, 24hr‐7days, 24‐34 wk GA)
• Exogenous surfactant greatly.
Risk factors:
White race, boys, prematurity (50% if <30 weeks).
Maternal diabetes, Genetic predisposition, multiple pregnancies, hypothermia, birth depression,
LSCS; lower segment cesarean section.
Tachypnea
Tachycardia
Intercostal retraction, nasal flaring, expiratory grunting
Cyanosis
Apnea
‐ Clinical diagnosis: At delivery or within 4 hours of birth.
‐ Decreased breath sounds bilaterally.
‐ Chest X ray: low lung volume, Complete opacification of both lung fields (white lung).
Homogenous "ground glass" opacity, Air bronchograms.
‐ CPAP & surfactant appearance may result affect x‐ray.
‐ ABG: hypercapnia, hypoxia & acidosis.
‐ Electrolytes, calcium, and glucose.
‐ Blood picture, CRP and ESR.
1. Prevention:
Antenatal steroids (Betamethasone and dexamethasone. 2‐4 days before delivery)
Avoiding drug depression and maternal fluid overload.
Cerebral brain injury when the brain doesn’t receive enough oxygen or blood flow. may develop
during pregnancy, labor and delivery or in the postnatal period.
Other causes: Septicemia, meningitis, Metabolic: hypoglycemia, hypo/hypernatremia,
Hypomagnesemia, Inborn errors of metabolism, Pyridoxine dependency.
Seizures Blood glucose level & Electrolytes.
Hypotonia Low heart rate.
Weak cry EEG
Organ dysfunction MRI
Hypotension can be an early sign of shock in adults, but not for children.
Respiratory tract:
• The upper respiratory tract:
nose and nasal passages, paranasal sinuses, the pharynx, and the portion of
the larynx above the vocal folds (cords).
Infections: Coryza, sore throat, earache, sinusitis, stridor.
• The lower respiratory tract:
• the larynx below the vocal folds, trachea, bronchi, bronchioles and alveoli.
• Infections: Bronchitis, bronchiolitis, & pneumonia
• Cough, wheeze, & respiratory distress.
Respiratory distress syndrome:
• RDS (hyaline membrane disease): commonest respiratory disorder in preterm babies &
leading cause of death.
• Caused by developmental insufficiency of surfactant leading to alveolar collapse ‐> V/Q
mismatch ‐> hypoxemia.
Complications:
Acute: Acidosis, air leaks, hypoglycemia, Chronic: ICH, pulmonary hemorrhage,
hypotension, atelectasis, infection, respiratory bronchopulmonary dysplasia, mental
failure & death. impairment.
, BPD (Bronchopulmonary dysplasia) or CLD (chronic lung disease) are most common in premature
babies or LBW babies who received prolonged mechanical ventilation to treat RDS.
In the last 3 decades, improvement of outcomes in RDS due to:
• Introduction of antenatal steroids. (2 doses, 12 hr apart, 24hr‐7days, 24‐34 wk GA)
• Exogenous surfactant greatly.
Risk factors:
White race, boys, prematurity (50% if <30 weeks).
Maternal diabetes, Genetic predisposition, multiple pregnancies, hypothermia, birth depression,
LSCS; lower segment cesarean section.
Tachypnea
Tachycardia
Intercostal retraction, nasal flaring, expiratory grunting
Cyanosis
Apnea
‐ Clinical diagnosis: At delivery or within 4 hours of birth.
‐ Decreased breath sounds bilaterally.
‐ Chest X ray: low lung volume, Complete opacification of both lung fields (white lung).
Homogenous "ground glass" opacity, Air bronchograms.
‐ CPAP & surfactant appearance may result affect x‐ray.
‐ ABG: hypercapnia, hypoxia & acidosis.
‐ Electrolytes, calcium, and glucose.
‐ Blood picture, CRP and ESR.
1. Prevention:
Antenatal steroids (Betamethasone and dexamethasone. 2‐4 days before delivery)
Avoiding drug depression and maternal fluid overload.
