Vol-2, Issue-1 Approach to Respiratory Distress in the Newborn
Newborn and Early Childhood Respiratory Disorders
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Transcript of Newborn and Early Childhood Respiratory Disorders
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Newborn and Early Childhood
Respiratory DisordersRT 265
Chapter 33
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Childhood Definitions Neonate
Birth to 1 month (first 28 days)
Infant 1 month to 1 year (some texts use until 3rd
year)
Pediatric 1 year to 12 years (some texts use until 21st
year)
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Development of the Respiratory System
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Lung Growth
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Transition at Birth Clear lung fluid High transpulmonary
pressures to open lungs Breathing must be
stimulated Pulmonary vasodilation,
decreased PVR Constriction of the
ductus arteriosus
Closure of umbilical blood supply closes ductus venousus
Increased SVR Closure of the
foramen ovale
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Pathophysiological Differences
Flexible compliant thorax Low lung compliance High negative intrapleural pressures during
inspiration
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Clinical Manifestations of
Distress Retractions Flaring nostrils Expiratory grunting Apnea of prematurity Persistent pulmonary hypertension of the
newborn
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Arterial Blood Gases Acute alveolar hypoventilation with
hypoxemia Acute ventilatory failure with hypoxemia
Low oxygen levels due to …… Pulmonary shunting and venous admixture PPHN Infant fatigue
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Apgar Score Scores:
0-3 – severe distress 4-6 – moderate distress 7-10 – absence of difficulty in adjusting to
extrauterine life
The 5 minute score should be higher than the 1 minute score
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Pediatric Patients Not “little adults” Differences in physiology affect drug dosing Requires equipment and techniques tailored
to size, weight, and age
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Newborn and Pediatric Assessment
Systematic collection of clinical data
Assessment of the data
Formulation of an appropriate treatment plan
Utilizing: Objective data Assessments Treatment plans
Apgar Score