Download RT 256 Common NewbornPed Resp Disorders

Newborn and Early
Childhood Respiratory
Disorders
RT 265
Chapter 33
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)
Development of the Respiratory
System
Lung Growth
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
Pathophysiological Differences
 Flexible compliant thorax
 Low lung compliance
 High negative intrapleural pressures during inspiration
Clinical Manifestations
of Distress
 Retractions
 Flaring nostrils
 Expiratory grunting
 Apnea of prematurity
 Persistent pulmonary hypertension of the newborn
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
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
Pediatric Patients
 Not “little adults”
 Differences in physiology affect drug dosing
 Requires equipment and techniques tailored to size,
weight, and age
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