新生儿学英语课件NeoResDistres专家讲座.pptx

Nonatology:Neonatal Respiratory Distress新生儿学英语课件NeoResDistres第1页Lecture Points Neonatal pulmonary functionClinical ManifestationThe main causes Main types of the diseaseCase discussion and presentationSummary and conclusion新生儿学英语课件NeoResDistres第2页Pulmonary function of the newborns in particular Relative small capacity of the lungs：limited reserved volume poor compensation,likely to be distressedRespiratory on abdomen and diaphragmatic movement Distension:likely to be respiratory distressedpulmonary surfactant(PS)relative in small amount in preterms and easily to be deficiencyDiseased lungs trends poor compliance and even ARDS新生儿学英语课件NeoResDistres第3页Neonatal Respiratory DistressGeneral picturecommonly occurs during neonatal period caused by various pathogeneses breath or 、irregular,apneaWith or without retraction at breathing,suprasternal and intercostalusually with cyanosis more or less 新生儿学英语课件NeoResDistres第4页Causation of neonatal respiratory distress Upper respiratory tract：choana,macrotongue,micrognathiaLarynx/throat and trachea：inteneratepulmonary disease：inflammation、abnormality or hypogenesisothers：congenital heart disease metabolic problems,CNS caused新生儿学英语课件NeoResDistres第5页Pathophysiology in neonatal respiratory distress hypoxic and/or hypoventilation hypoxemia,PCO2 respiration center peripheral biochemical sensors breath or 、irregular,apnea新生儿学英语课件NeoResDistres第6页 Neonatal Respiratory DistressHyaline Membrane Disease （HMD、RDS)Neonatal infectious PneumoniaMeconium Aspiration Syndrome(MAS)for differentiation新生儿学英语课件NeoResDistres第7页Hyaline Membrane Disease（HMD/RDS）Clinical manifestation pretermsnormal at birth,respiratory distressed in several hours after birthprogressively developing and deterioration self cured process during the sickness 新生儿学英语课件NeoResDistres第8页Clinical manifestation After birth commonly seen,intrauterine infectious pneumonia relatively less seen Occurring in neonates with different GAs and agesGeneral appearance of infection Various in severity of respiratory distressBlood-gas：PaO2 、PaCO2 Neonatal infectious Pneumonia新生儿学英语课件NeoResDistres第9页 Meconium Aspiration Syndrome(MAS)Clinical manifestationTerms and post-terms commonly seenHistory of intrauterine distressamniotic fluid stained by meconiumLower Apgars scoreDistress occurs soon after birthTachypnea and withdrawal at breathing Blood-gas：PaO2 ,PaCO2 and acidosis新生儿学英语课件NeoResDistres第10页CXR:HMD新生儿学英语课件NeoResDistres第11页CXR:pneumonia 新生儿学英语课件NeoResDistres第12页CXR:MAS新生儿学英语课件NeoResDistres第13页CXR:MAS 新生儿学英语课件NeoResDistres第14页Clinical management for neonatal respiratory distressMonitoringGeneral appearance：T;response,skin color,feeding tolerance respiration（frequency,pattern and apnea）Other systems:HR,liver,abdomen Blood-gas,Pa O2、SaO2新生儿学英语课件NeoResDistres第15页Clinical management for neonatal respiratory distressOxygen therapyNasal tubeMask and tent Pressed facial maskAttention!fio2 O2 concentration ROP,CLD/BPD新生儿学英语课件NeoResDistres第16页Clinical management for neonatal respiratory distressMechanical ventilationTarget：early intervention and early withdrawIndication：persistent cyanosis under oxygen therapy Remarkable SaO2 PaO2 and/or PaCO2 indicated by ABG 新生儿学英语课件NeoResDistres第17页Clinical management for neonatal respiratory distressMechanical ventilationVentilation modes and parametersContinuous positive airway pressure(CPAP)：4-8 cmH2O;Assistant/control(A/C)：PIP 15-25 cmH2O；RR 25-35；I/E：1：1.5-2.5；PEEP：4-12 cmH2OPressure support ventilation(PSV)：6-10 cmH2OHigh frequency oxillation ventilation:HFOV新生儿学英语课件NeoResDistres第18页Clinical management for neonatal respiratory distressMedicationantibiotics penicillin:10-40 万万u/kg/d ampicillin:50-75mg/kg/d cephalosporin:25-50mg/kg/dPS:80-120 mg/kg,1 to 2 dose 新生儿学英语课件NeoResDistres第19页Clinical management for neonatal respiratory distressKeep the baby warmIncubator Radiator Stable room tempereture新生儿学英语课件NeoResDistres第20页Clinical management for neonatal respiratory distressClinical nutritionFeeding:Breast milk/Formulas decreasing volume feeding as neededParenteral nutrition（T/PPN）新生儿学英语课件NeoResDistres第21页Thanks for listening Questions please?新生儿学英语课件NeoResDistres第22页