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    Dr. Fartun Orey MBCHB, Mmed Paed

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    Cabdiladif Ahmed Mcrf
    This document discusses several common causes of respiratory distress in newborns including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and meconium aspiration syndrome (MAS). It provides details on the risk factors, manifestations, treatment, and prevention of RDS. TTN is described as a self-limited condition causing tachypnea without severe distress. MAS can range from mild to severe and is associated with meconium passage and asphyxia.

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    Dr. Fartun Orey MBCHB, Mmed Paed

    Uploaded by

    Cabdiladif Ahmed Mcrf
    39 views14 pages
    This document discusses several common causes of respiratory distress in newborns including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and meconium aspiration syndrome (MAS). It provides details on the risk factors, manifestations, treatment, and prevention of RDS. TTN is described as a self-limited condition causing tachypnea without severe distress. MAS can range from mild to severe and is associated with meconium passage and asphyxia.

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    Rds

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    This document discusses several common causes of respiratory distress in newborns including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and meconium aspiration syndrome (MAS). It provides details on the risk factors, manifestations, treatment, and prevention of RDS. TTN is described as a self-limited condition causing tachypnea without severe distress. MAS can range from mild to severe and is associated with meconium passage and asphyxia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    39 views14 pages

    Dr. Fartun Orey MBCHB, Mmed Paed

    Uploaded by

    Cabdiladif Ahmed Mcrf
    This document discusses several common causes of respiratory distress in newborns including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and meconium aspiration syndrome (MAS). It provides details on the risk factors, manifestations, treatment, and prevention of RDS. TTN is described as a self-limited condition causing tachypnea without severe distress. MAS can range from mild to severe and is associated with meconium passage and asphyxia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    RDS

    Dr. Fartun Orey


    MBChB, MMED PAED
    Differential Diagnosis

    Pulmonary Parenchymal Disease


    Respiratory Distress Syndrome (RDS)
    Transient Tachypnea of the Newborn (TTN)
    Meconium Aspiration
    Interference with Pulmonary Mechanics
    Pneumothorax
    Pleural Effusion
    Congenital Diaphragmatic Hernia (CDH)
    Pulmonary Hypoplasia
    Thoracic Wall abnormalities
    Space occupying lesions
    Differential Diagnosis

    Cardiovascular
    Congenital Heart Disease: Cyanotic
    Acyantotic
    Persistent Pulmonary Hypertension of Newborn
    Anemia/Polycythemia
    Neurologic
    Perinatal Aphyxia (apnea,cerebral
    edema and hemorrhage)
    Maternal Drugs (narcotics, anesthesia)
    Phrenic nerve injury
    Neuromuscular disorders (myasthenia, spinal atrophy)
    Differential Diagnosis

    Infectious
    Pneumonia
    Sepsis
    Metabolic
    Acidosis
    Hypoglycemia
    Hypothermia
    Most Common Respiratory
    Conditions
    Transient Tachypnea of Newborn (TTN)
    Respiratory Distress Syndrome (RDS)
    Meconium Aspiration Syndrome (MAS)
    Sepsis
    Pneumonia
    RESPIRATORY DISTRESS SYNDROME

     RDS occurs after the onset of breathing and is


    associated with an insufficiency of pulmonary
    surfactant.
     Surfactantdeficiency–induced atelectasis
    causes alveoli to be perfused but not
    ventilated, which results in a pulmonary shunt
    and hypoxemia.
    Risk factors

     Prematurity
     Infant of diabetic mother
     Hypothermia,
     Fetal distress
     Asphyxia,
     Male sex, white race,
     Being the second-born of twins,
     And delivery by cesarean section without labor
    Manifestations
     Cyanosis, tachypnea, nasal flaring, intercostal and
    sternal retractions, and grunting.
     Chest x.ray shows a ground-glass haze in the lung
    surrounding air-filled bronchi (the air bronchogram)
     Severe RDS may show an airless lung field (whiteout)
     During the first 72 hours, infants with untreated RDS
    have increasing distress and hypoxemia.
     In infants with severe RDS, develop edema, apnea, and
    respiratory failure necessitates assisted ventilation.
    Prevention

     Prevention of preterm birth neonatal cold


    stress, birth asphyxia, and hypovolemia
    reduces the risk of RDS.
     Antenatal administration of corticosteroids
    (e.g., betamethasone) to the mother.
     Intratrachealadministration of exogenous
    surfactant immediately after birth
    Treatment
     The Pao2 level should be maintained between 60 and 70
    mm Hg (oxygen saturation 90%), and the pH should be
    maintained above 7.25.

     Ifhypoxemia (Pao2 <50 mm Hg) is present, and the


    needed inspired oxygen concentration is 70% to 100%,
    nasal continuous positive airway pressure (CPAP).

     Ifrespiratory failure ensues (Pco2 >60 mm Hg, pH <7.20,


    and Pao2 <50 mmHg with 100% oxygen), assisted
    ventilation using a ventilator is indicated.
    TRANSIENT TACHYPNEA OF THE NEWBORN

     Transient tachypnea of the newborn is a self-limited condition


    characterized by tachypnea, mild retractions, hypoxia, and
    occasional grunting, usually without signs of severe respiratory
    distress.

     Noted in larger premature infants and in term infants born by


    precipitous delivery or cesarean section without prior labor and
    infant of diabetic mother.

     Transient tachypnea of the newborn may be caused by retained lung


    fluid or slow resorption of lung fluid.
    Muconium aspiration syndrome
     Usually
    associated with in utero passage of
    meconium, meconium stained fluid

     Associated with asphyxia (fetal heart rate pattern


    abnormalities)
     Increased risk in postdates, IUGR

     Aspiration may lead to patchy alveolar disease,


    air trapping (ball-valve), chemical pneumonitis,
    persistent pulmonary hypertension

     Can cause surfactant inactivation


    Clinical manifestation

     Mild disease: similar to TTN

     Moderate disease: gradual increase in


    respiratory distress with rising 02 needs

     Severe
    disease: Early respiratory symptoms,
    may be associated with severe hypoxemia.
    Management
     Early preventive management:
     Intubation and endotracheal suctioning in infants
    in non-vigorous infant with meconium.
     Diagnosis:
     Hypoxemia
     Respiratorydistress (grunting, flaring, retractions,
    and tachypnea)
     CXR
     Coarse irregular patchy infiltrates
     Hyperinflation

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