03 RESPIRATORY DISTRESS IN NEW BORNSBORN.pptx

this is on respiratory distress in new borns definition clinical presentation and managment in neonates

1. Yirgalem medical college department of pediatrics and child health Dr. Yohanes Hailu(Pediatrician) 11/26/2015 1

2. Respiratory distress in the newborn Respiratory distress is presence of one or more of the following: Tachypnea RR>=60 Flaring of ala nasi Grunting Cyanosis in room air. Chest indrowing. 11/26/2015 2

3. Causes of Respiratory Distress in the Newborn Noncardiopulmonary   Hypothermia or hyperthermia Hypoglycemia Polycythemia Metabolic acidosis Drug intoxications or withdrawal  Insult to the central nervous system Asphyxia      Hemorrhage Neuromuscular disease    Phrenic nerve injury 11/26/2015 3

4. Cont… Cardiovascular      Left-sided outflow tract obstruction      Hypoplastic left heart      Aortic stenosis      Coarctation of the aorta    Cyanotic lesions      Transposition of the great vessels      Total anomalous pulmonary venous return      Tricuspid atresia      Right-sided outflow obstruction 11/26/2015 4

5. Cont… Pulmonary      Upper airway obstruction      Choanal atresia      Vocal cord paralysis      Lingual thyroid   Micrognathia. Retrognathia . Macroglosia . Congenital goiter and cystic hygroma. Laryngomalacia . Tracheomalacia   11/26/2015 5

6. Cont… Meconium aspiration    Clear fluid aspiration    Transient tachypnea    Pneumonia 11/26/2015 6

7. Cont… Pulmonary hypoplasia    Hyaline membrane disease    Pneumothorax    Pleural effusions Pulmonary hypoplasia. Diaphragmatic hernia Mass lesions      Lobar emphysema      Cystic adenomatoid malformation 11/26/2015 7

8. Treatment Principles of management ABC of life Initiate breathing by; Tactile stimulation Bag and mask ;contraindicated in MAS and indiaphramatic hernia . 11/26/2015 8

9. Cont… Supplemental oxygen sufficient to maintain a PaO 2 of 60–70 mm Hg and an oxygen saturation by pulse oximetry (SpO 2 ) of 92–96%. Assisted ventilation via CPAP, or intubation with mechanical ventilation , may be needed for infants with respiratory failure (PaO 2 < 60 mm Hg in 60–80% FIO 2 , PaCO 2 greater than 60 mm Hg, or repeated apnea). Maintain circulation 11/26/2015 9

10. Cont… Empiric antibiotics , typically ampicillin and gentamicin, should be considered if there is delayed transitioning, progressive respiratory distress, or if sepsis risk factors are present. Initiate specific treatment for specific disease. 11/26/2015 10

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