MD1TALK
Res distress in neonate🌟
Causes divided into:
RES:
1)RDS
2)TTN
3)MAS
Non Res:
1)Cvs: cyanotic CHD
2)Heme: anemia or poly
3)Other: infectious and metabolic.
1- Respiratory distress syndromes (RDS) previously known
hyaline membrane disease:
CAUSE: Due to lack of surfactant which is phospholipid protein
that decrease surface tension inside alveoli → prevent collapse
typically seen in preterm Before 32w → no surfactant synthesis at this
age.
Other Causes of RDS: ventilation problem (either collapse\infection)
Complication: most common cause of respiratory failure during
first days after birth
Management:
Supportive PLUS CPAP
surfactant administration (if no response for CPAP)
(Side effect: pulmonary hemorrhage)
Prevention: Steroids (betamethasone) 1-2 days before labour
will accelerate alveolar type-II (AT-II) cells to secrete surfactant → so
given to pregnant lady suspected to deliver early at gestation.
Investigation:
-CBC -electrolyte - CRP - blood culture - ABG: first change is
hypoxemia followed by hypercapnia followed by res acidosis.
Best initial CXR: bilateral, diffuse, hazy patchy areas of increased
opacity With ground glass appearance.
Best diagnostic: lecithin – sphingomyelin ratio ratio done amniotic fluid
at delivery → 2:1 represents fetal lung maturity → less 2;1
, MD1TALK
case: 29w neonate delivered by c-section , no maternal disease ,
apgar score 4 - 4,5 shifted to icu and connected to o2 baby was
manifesting central cyanosis and acrocynaosis - intercostal recession -
slightly hypotonic
DDx: sepsis or RDS
2- Transient tachypnea of newborn:
age: In term infant.
symptoms: present within first few hours of life with signs of
respiratory distress (tachypnea, nasal flaring, grunting, retractions,
hypoxia, increased and cyanosis in extreme cases)
Investigations: ABG: may reveal no hypercapnia.
Causes: associated with c section due child didn't pass through
labour process and didn't have catecholamines surge → poorly
developed respiratory epithelial Na+ channel that help in absorption of
fluid → delay of absorption of lung fluid
CXR: perihilar streaking (White or more opaque lines are seen
radiating out from the hilar region) and fluid in fissure and blunting of CP
angles.
Res distress in neonate🌟
Causes divided into:
RES:
1)RDS
2)TTN
3)MAS
Non Res:
1)Cvs: cyanotic CHD
2)Heme: anemia or poly
3)Other: infectious and metabolic.
1- Respiratory distress syndromes (RDS) previously known
hyaline membrane disease:
CAUSE: Due to lack of surfactant which is phospholipid protein
that decrease surface tension inside alveoli → prevent collapse
typically seen in preterm Before 32w → no surfactant synthesis at this
age.
Other Causes of RDS: ventilation problem (either collapse\infection)
Complication: most common cause of respiratory failure during
first days after birth
Management:
Supportive PLUS CPAP
surfactant administration (if no response for CPAP)
(Side effect: pulmonary hemorrhage)
Prevention: Steroids (betamethasone) 1-2 days before labour
will accelerate alveolar type-II (AT-II) cells to secrete surfactant → so
given to pregnant lady suspected to deliver early at gestation.
Investigation:
-CBC -electrolyte - CRP - blood culture - ABG: first change is
hypoxemia followed by hypercapnia followed by res acidosis.
Best initial CXR: bilateral, diffuse, hazy patchy areas of increased
opacity With ground glass appearance.
Best diagnostic: lecithin – sphingomyelin ratio ratio done amniotic fluid
at delivery → 2:1 represents fetal lung maturity → less 2;1
, MD1TALK
case: 29w neonate delivered by c-section , no maternal disease ,
apgar score 4 - 4,5 shifted to icu and connected to o2 baby was
manifesting central cyanosis and acrocynaosis - intercostal recession -
slightly hypotonic
DDx: sepsis or RDS
2- Transient tachypnea of newborn:
age: In term infant.
symptoms: present within first few hours of life with signs of
respiratory distress (tachypnea, nasal flaring, grunting, retractions,
hypoxia, increased and cyanosis in extreme cases)
Investigations: ABG: may reveal no hypercapnia.
Causes: associated with c section due child didn't pass through
labour process and didn't have catecholamines surge → poorly
developed respiratory epithelial Na+ channel that help in absorption of
fluid → delay of absorption of lung fluid
CXR: perihilar streaking (White or more opaque lines are seen
radiating out from the hilar region) and fluid in fissure and blunting of CP
angles.
