Tiny, 27 weeks, male neonate, NSVD in a taxi

Who was

BW of 900g; BL of 36 cm; HR of 180bpm; RR of 68/min

Presented with

Poor cry, expiratory

grunting, intercostal & Lipsmacking & twitching Machinery-like murmur
subcostal retractions, of eyelids at precordial area
rales in both lung fields

Suggestive of Suggestive of Suggestive of

Respiratory Distress Seizures

can usually
be due to
Surfactant defeciency
can lead to
Hyaline membrane
deposition
can show
Marked thickening of
alveolar septa &
proliferation of interstitial
cells
Usually presents with
Rapid, shallow breathing
≥60cpm
Which has an
Ominous signs: Apnea &
irregular respirations
can be lead to
Death if untreated
can be diagnosed by
Clinical course, CXR, ABG,
& acid-base value;
hypoxemia, hypercapnia, can be treated with
metabolic acidosis
can be prevented by
can usually
be due to
Hypoxic-ischemic
encephalopathy
can show
Rhythmic twitching of
muscle groups
Classified as
Multifocal clonic
convulsions -- involves
many muscle groups;
tonic seizures -- rigid upper sternal border or L
posturing of extremities
& trunk; myoclonic
seizures -- brief focal or
d/t ↑ blood flow across
generalized jerks or
extremities; subtle
seizures -- chewing
motions, excessive
salivation, altered
respiratory rate
can be diagnosed by
Lumbar puncture,
newborn screening, MRI
or CT, serum glucose,
calcium, or electrolyte
measurements
Treat underlying cause
Patent Ductus Arteriosus
Which is
Most often related to
hypoxia and immaturity;
term infants with PDA
usually have structural
defects in ductal vessel
walls
can be diagnosed by
Examination: Systolic
CXR: ± Echocardiogram
murmur best heard at L cardiomegaly &
↑ pulmonary
infraclavicular area, ± vascular
apical diastolic rumble
markings,
depending on
MV; Hyperactive size of shunt
precordium
can be treated with
ECG: Normal or LVH Indomethacin;
in small to moderate Ibuprofen;
PDA; Biventricular surgical ligation
hypertrophy in large of the duct
PDA

Avoiding unnecessary or
poorly times cesarean
section, appropriate
management of high-risk
pregnancy & labor,
prediction of pulmonary
immatuirty; avoid fetal
asphyxia; antenatal
corticosteroids
can be treated with

Incubator, CPAP,
[ermissive hypercapnia,
high-frequency
ventilation; exogenous
surfactant (exosurf,
survanta, infasurf,
curosurf); inhaled nitric
oxide

can lead to

Pneumothorax, air leaks,

asphyxia, bradycardia,
subglottic stenosis