respiratory issues in fetus

how can respiratory issues come about ?

• issues in baby’s lungs trying to go from fluid filled to air filled

• issues with airway resistance decreasing in other for the increase in functional residual capacity (which supports the oxygination)

what are the common respiratory problems?

1. transient tachypnoea of the newborn

2. persistent pulmonary hypertention of the newborn

3. meconium aspiration syndrome

4. respiratory distress syndrome (RDS)
   

transient tachypnoea of the newborn

• the lungs are not fully cleared of the fluid

• causing problems with gas exchange

persistent pulmonary hypertention of the newborn

• blood pressure doen’t fall causing issues with oxygination

meconium aspiration syndrome

• if baby breathes meconium stained fluid

• baby can aspirate & develop aspiration pneumonia

respiratory distress syndrome (RDS)

• caused by deficiency in surfactant

• mainly affects pre-term but can affected babies from diabetic mum or babies that develop asphyxia at birth

what is curosurf

• artificial surfactant

• baby must be intubated

what is surfactant

• fat-based layer that lines the airway preventing the lungs from sticking together

• produced by alveolar cells- fully by 28 wwks (not mature until 34 wwks)

who are surfactants given to

• neonates with RDS or other respiratory distress conditions

• “ “ < 32 wwks

• “ “ needing >40% 02

respiratory distress signs

1. range outside of 30-60 breaths x min

2. recessions (resistance to air entry is increased so the effort to inahle pulls immature muscles inwards)

3. nasal flaring

4. head bobbing
   

tachypnia

• > 60 bpm

• (body conpensating for changes in blood gases & pH in body e.g. decreased 02, increased CO2)
  

respiratory assessment

1. take detailed history

2. count resps & auscultate lungs (listen out for clear lungs)

3. check skin colour

4. check pattern of breathing - baby should breathe through nose

5. think about why your concerned for this baby

6. look out for symmetry of the chest (assymatry may indicate pneumothorax)

unsual breathing

• stridor - high pitched noise on inspiration

• wheeze- variable pitch heard in expiration

• grunting- sudden expiratory sound due to the glotts closing

• crackles- short intermitted sounds during expiration

• plerual rob- inflammed plerual noises

physiological reasons neonates struggle to breathe

• small delicate airway

• reduced alveolar surface area

• residual lung fluid following delivery
  

what 2 do if baby is struggling to breathe

• 5 infaltion breaths

• listen to HR

• (if HR still not up) inflation breaths again

• 3 cardiac pushes x 1 ventilation breath

antenatal steroids