5. Perinatal Asphyxia & Newborn Respiratory Disorders

what is perinatal asphyxia?

impaired gas exchange around birth causing hypoxemia, hypercarbia, and acidosis

what is the immediate priority for a newborn with perinatal asphyxia?

resuscitation to support airway, breathing, and circulation

what temperature is used for therapeutic hypothermia after perinatal asphyxia?

33.5°C;helps limit brain injury in eligible newborns

how long is therapeutic hypothermia continued after perinatal asphyxia?

72 hours

what causes transient tachypnea of the newborn?

delayed clearing of fetal lung fluid

what are major risk factors for transient tachypnea of the newborn?

cesarean birth;prematurity;maternal diabetes;precipitous delivery

what are signs of transient tachypnea of the newborn?

RR above 60/min;grunting;nasal flaring;retractions;labored breathing

when should transient tachypnea of the newborn resolve?

within 72 hours

how is transient tachypnea of the newborn treated?

supportive care and supplemental oxygen as needed

how should oral feeding be managed when a newborn is significantly tachypneic?

keep NPO to prevent aspiration;IV fluids or ordered gavage feeding

what causes respiratory distress syndrome in a preterm newborn?

surfactant deficiency causing alveolar collapse

when does fetal surfactant production develop?

begins around 26 weeks;reaches mature levels around 35 weeks

what medications are given to the mother to promote fetal lung maturity before preterm birth?

betamethasone;dexamethasone

what are signs of newborn respiratory distress syndrome?

expiratory grunting;tachypnea and tachycardia;generalized cyanosis;increased work of breathing;seesaw respirations

what are seesaw respirations?

chest and abdomen move in opposite directions during breathing

how is newborn respiratory distress syndrome treated?

surfactant;CPAP;ventilation with PEEP

what is meconium aspiration syndrome?

inhalation of meconium in utero or with the first breaths

what are major risk factors for meconium aspiration syndrome?

postterm birth;fetal hypoxia;placental insufficiency;oligohydramnios

how does aspirated meconium injure the lungs?

airway obstruction;surfactant dysfunction;chemical pneumonitis;hypoxia

what findings suggest meconium aspiration syndrome?

yellow-green staining of skin, nails, or cord;respiratory distress;coarse crackles or rhonchi

when is deep suctioning used for a newborn exposed to meconium?

when airway obstruction prevents effective ventilation;not routinely for meconium alone

what respiratory treatment may be needed for meconium aspiration syndrome?

oxygen and ventilatory support;surfactant;nitric oxide or ECMO in severe cases