Respiratory Distress Syndrome (RDS)

فهرست عناوین اصلی در این پاورپوینت

فهرست عناوین اصلی در این پاورپوینت

● Disclosures
● Objectives
● Introduction
● Clinical Presentation
● Narrowing the Differential
● Case Studies
● Case #1
● Transient Tachypnea of the Newborn (TTN)
● TTN Risk Factors
● TTN: Clinical Findings
● TTN: Radiographic Findings
● TTN: Typical Course
● Case #2
● Case # 2 Continued
● Respiratory Distress Syndrome (RDS)
● RDS Continued
● Respiratory Distress Syndrome: Clinical Finings
● RDS: Typical Course
● Case #3
● Case # 3 Continued
● Meconium Aspiration Syndrome (MAS)
● Meconium Aspiration Syndrome: Clinical Presentation
● Meconium Aspiration Syndrome: Typical Course
● Case #4
● Congenital Pneumonia: Clinical Presentation
● Pneumonia: Epidemiology
● Congenital Pneumonia: Typical Course
● Other Pulmonary Causes of Respiratory Distress
● Non-Pulmonary Causes of Respiratory Distress:

Congenital Heart Disease
● Congenital Heart Disease
● Differentiating CHD from Pulmonary Disease
● Management of the Newborn
with Respiratory Distress
● Initial Assessment: “ABCs”
● Initial Assessment, continued
● Clues from the History?
● Objective Data
● Management
● So when to transport?!
● Take-Home Points
● How to Arrange Transport?
● References
● We’re online!
● Thank You!

نوع زبان: انگلیسی حجم: 7.04 مگا بایت
نوع فایل: اسلاید پاورپوینت تعداد اسلایدها: 55 صفحه
سطح مطلب: نامشخص پسوند فایل: ppt
گروه موضوعی: زمان استخراج مطلب: 2019/06/06 12:13:28

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عبارات مهم استفاده شده در این مطلب

عبارات مهم استفاده شده در این مطلب

., respiratory, distress, pulmonary, newborn, cause, congenital, tachypnea, case, lung, syndrome, infant,

توجه: این مطلب در تاریخ 2019/06/06 12:13:28 به صورت خودکار از فضای وب آشکار توسط موتور جستجوی پاورپوینت جمع آوری شده است و در صورت اعلام عدم رضایت تهیه کننده ی آن، طبق قوانین سایت از روی وب گاه حذف خواهد شد. این مطلب از وب سایت زیر استخراج شده است و مسئولیت انتشار آن با منبع اصلی است.

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عبارات پرتکرار و مهم در این اسلاید عبارتند از: ., respiratory, distress, pulmonary, newborn, cause, congenital, tachypnea, case, lung, syndrome, infant,

مشاهده محتوای متنیِ این اسلاید ppt

مشاهده محتوای متنیِ این اسلاید ppt

mark bergeron md mph associates in newborn medicine pa st. paul assistant professor pediatrics university of minnesota medical school ttn vs. ttt time to transport assessment of neonatal respiratory distress children’s march of dimes neonatal conference may ۱۷ ۲ ۱ disclosures i will not be discussing any experimental or off label uses for any therapies during this presentation. i have no relevant financial relationships to declare. objectives formulate a differential diagnosis for the infant in respiratory distress. describe initial stabilization measures for the infant in respiratory distress. describe situations where ongoing respiratory distress requires transfer to a nicu for further management. introduction respiratory distress is a frequent problem in the newborn period. most common indication for evaluation or re evaluation of the newborn infant affects as many as ۷ of newborns potentially life threatening must be promptly assessed and managed by an on site provider in the delivery room or newborn nursery clinical presentation apnea cyanosis grunting stridor nasal flaring retractions subcostal intercostal suprasternal tachypnea ۶ min gasping choking image aly h. pediatrics in review ۲ ۴ narrowing the differential pulmonary transient tachypnea of the newborn ttn respiratory distress syndrome rds meconium aspiration syndrome pneumonia sepsis pneumothorax persistent pulmonary hypertension pphn non pulmonary congenital cyanotic heart disease congenital airway anomalies other neurologic hematologic metabolic endocrine maternal etc. case studies case ۱ ۳.۶ kg term newborn female ۲ minutes old has tachypnea and acrocyanosis. she is ۴ weeks ega delivered by scheduled repeat c section and apgar scores were ۷ and ۸ at ۱ and ۵ minutes respectively. vitals are normal with the exception of a respiratory rate of ۸۴ and exam is notable for slight subcostal retractions but otherwise normal. over the next several hours her respiratory rate steadily improves to the ۴ s and her acrocyanosis resolves. transient tachypnea of the newborn ttn most common etiology of newborn respiratory distress. ۱۱ ۱ live births represents ۴ of cases of newborn respiratory distress. caused by delayed clearance of fetal lung fluid in both term and preterm infants ttn risk factors at birth air spaces rapidly clear fluid from lung expansion with air promoted by labor maternal epinephrine surge guglani et al. pediatrics in review ۲ ۸ ttn clinical findings history c s nsvd exam tachypnea grunting nasal flaring retractions transient oxygen need lab mild respiratory acidosis or normal blood gas ttn radiographic findings chest x ray increased interstitial markings wet lung increased fluid in interlobar fissures image aly h. pediatrics in review ۲ ۴ ttn typical course usually benign self limited occasionally requires therapy oxygen ncpap mechanical ventilation diuretics not effective i.e. lasix typically resolves by ۲ days of age no lasting sequalae case ۲ ۱.۲ kg male infant born vaginally at ۳۲ weeks ega apgars ۶ ۸ required bulb suctioning brief ppv. grunting retractions nasal flaring acrocyanosis immediately after birth. vs hr ۱۷۸ rr ۷۹ mean bp ۳۹ mmhg. o۲ sat ۷۴ ۷۸ in room air. case ۲ continued lab cbc unremarkable abg ۷.۲۶ ۶۷ ۵۸ ۱۹ cxr prominent reticulogranular pattern uniformly distributed with hypoaeration of lungs. increased air bronchograms are observed. respiratory distress syndrome rds also called hyaline membrane disease. most common cause of respiratory distress in preterm infants. due to structural and functional immaturity of lungs. underdeveloped parenchyma surfactant deficiency type ii pneumatocytes results in decreased lung compliance unstable alveoli rds continued risk factors prematurity ۲۸ weeks ga ≈۱ ۲۸ ۳۴ weeks ga ۳۳ ۳۴ weeks ga ۵ perinatal depression male predominance maternal diabetes c section multiple birth respiratory distress syndrome clinical finings exam moderate to severe respiratory distress tachypnea grunting apnea retractions nasal flaring cyanosis lab moderate hypoxia respiratory acidosis metabolic acidosis delayed x ray low lung volumes diffuse atelectasis ground glass opacities air bronchograms difficult to distinguish from pneumonia rds typical course prevention antenatal bethamethasone arrest of preterm labor treatment oxygen supplementation assisted ventilation ncpap mechanical ventilation fio۲ .۴ exogenous surfactant replacement fluid restriction outcome peak severity ۱ ۳ days recovery coincides with diuresis beginning at ۷۲ hrs severe cases evolve into bronchopulmonary dysplasia chronic lung disease extreme prematurity prolonged mechanical ventilation sepsis case ۳ ۴.۲ kg female infant is cyanotic and tachypneic at ۳ minutes of age following a vaginal delivery through meconium stained amniotic fluid. apgar scores were ۳ and ۶. she had a spontaneous but weak cry at birth and received some positive pressure ventilation followed by suctioning. vitals signs reveal a pulse of ۱۶۹ respiratory rate of ۱۱۵ and a mean bp of ۵۵. sats are ۷۶ despite ۱ o۲ by headbox. she is barrel chested retracting grunting and has diminished coarse breath sounds bilaterally. she is electively intubated lines placed and labs sent. case ۳ continued lab cbc nl abg ۷.۱۹ ۷۲ ۳۶ cxr image aly h. pediatrics in review ۲ ۴ meconium aspiration syndrome mas meconium staining of amniotic fluid complicates nearly ۱۵ of all deliveries. fetal distress primarily term and post term meconium can be aspirated before during or after delivery. once aspirated meconium causes chemical pneumonitis mechanical obstruction ball valve with severe air trapping pneumothoraces ۱ ۲ surfactant inactivation severe hypoxemia and hypoventilation v q mismatch meconium aspiration syndrome clinical presentation exam air trapping with barrel chest moderate to severe respiratory distress rales and or rhonchi hypoxia with cyanosis hypoperfusion lab acidosis respiratory and metabolic cxr hyperinflation overdistension diffuse patchy intraparenchymal opacities meconium aspiration syndrome typical course prevention nrp treatment oxygen mechanical ventilation high frequency jet oscillator surfactant replacement complications sepsis pneumonia airleaks pneumothorax pneumopericardium persistent pulmonary hypertension pphn treated with inhaled nitric oxide ino ecmo resolution days to weeks mortality ۱ ۱۲ case ۴ ۳.۹ kg male infant develops poor feeding tachypnea and mild oxygen need at ۱۴ hrs of life. exam equal and clear breath sounds with tachypnea. otherwise unremarkable. labs wbc ۴.۳ x ۱ ۳ abg nl electrolytes and glucose acceptable. cxr congenital pneumonia clinical presentation most common neonatal infection wide variety of presenting signs varying degree of respiratory distress lethargy poor feeding apnea temperature instability high or low cxr can look like anything mild focal opacities pleural effusion s complete white out normal pneumonia epidemiology hematogenous vs. aspiration acquisition antenatal perinatal or postnatally acquired common organisms antenatal rubella cmv hsv adenovirus toxoplasma gondii treponema pallidum mycobacterium tuberculosis listeria monocytogenes varicella zoster and others perinatal gbs e. coli klebsiella chlamydia trachomatis postnatal adenovirus rsv streptococcus staphylococcus gram negative enterics congenital pneumonia typical course transient oxygen need gradual resolution of tachypnea antibiotic ampicillin gentamicin therapy ۵ ۷ days unless complicated by sepsis or for specific organism requiring longer courses of therapy other pulmonary causes of respiratory distress other pulmonary causes of respiratory distress congenital diaphragmatic hernia other pulmonary causes of respiratory distress esophageal atresia tracheoesophageal fistula other pulmonary causes of respiratory distress congenital cystic adenomatoid malformation ccam pulmonary sequestrations other pulmonary causes of respiratory distress pneumothorax neopix non pulmonary causes of respiratory distress congenital heart disease congenital heart disease cyanotic transposition of the great arteries total anomalous pulmonary venous return tricuspid atresia tetralogy of fallot truncus arteriosus pulmonary atresia severe chf ebstein’s anomaly double outlet right ventricle acyanotic hypoplastic left heart syndrome interrupted aortic arch critical aortic stenosis patent ductus arteriosus vsd asd av canal defect coarctation of the aorta valvular defects may present as cyanotic or acyanotic congenital heart …

کلمات کلیدی پرکاربرد در این اسلاید پاورپوینت: ., respiratory, distress, pulmonary, newborn, cause, congenital, tachypnea, case, lung, syndrome, infant,

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