HGD - pulmonary disorders

• Intermittent apnea / bradycardia

• Infant Respiratory Distress Syndrome / Hyaline Membrane Disease (HMD)

Related to Prematurity

• BPD

related to LT (+) pressure ventilation

• Meconium Aspiration Syndrome

• Transient Tachypnea of Newborn (TTNB)

Occurring at Birth

• SIDS

Occurring After Birth

• Cystic Fibrosis

Congenital

Apnea of Prematurity are transient periods of

apnea that last 15-20 sec

typically accompanied by bradycardia

What is the most common respiratory disorder of premature infants born under 37 weeks GA?

Hyaline Membrane Disease (HMD)

Neonatal or Infant Respiratory Distress Syn (NRDS / IRDS)

The etiology of Hyaline Membrane Disease / Neonatal or Infant Respiratory Distress Syndrome involves

Inadequate surfactant production + lung immaturity

→ hypoxemia due to lack of gas exchange

Bronchopulmonary Dysplasia (BPD) is linked to long term

positive pressure ventilation and O2 therapy

Bronchopulmonary Dysplasia (BPD) may be associated with

CP outcome or neurological sequlae

Bronchopulmonary Dysplasia (BPD) may progress to s/s consistent with

chronic restrictive lung disease

s/s consistent with chronic restrictive lung disease include all of the followig EXCEPT

Decreased incidence of respiratory infection

Meconium Aspiration Syndrome involves infants that aspirates mixature of

meconium (contents of bowels) + amniotic fluid

Meconium Aspiration Syndrome occurs within

first few postnatal breaths

Meconium Aspiration Syndrome may cause

airway obstruction and atelectasis

Meconium Aspiration Syndrome puts infant at tisk for

tension pneumothorax, pulm HTN, bronchiolitis and pneumonitis

Transient Tachypnea of Newborn (TTNB) is respiratory distress caused by

delayed clearance of fetal lung fluid

Transient Tachypnea of Newborn (TTNB) usually corrects with

little more than observation (self limiting)

Sudden Infant Death Syndrome =

Unexplained death of an infant < 1 year of age

Possible etiologies inckude all of the following EXCEPT

Back to Sleep Campaign – started in 1994 has

dramatically reduced incidence

Cystic Fibrosis is a(n)

autosomal-recessive disease affecting exocrine gland function

90% of CF related deaths are due to

pulmonary compromise

How can PTs play an important role in cystic fibrosus?

• Postural Drainage • Airway clearance • Rib cage mobility • Postural training • General exercise

A complete diagnostic evaluation of cyctic fibrosus should include all of the following EXCEPT

Family genetic testing

What is screened for newborns suspected of having cystic fibrosis?

Levels of of Immunoreactive Trypsinogen (IRT)

Increased levels of Immunoreactive Trypsinogen are seen in

preemies

stressful deliveries

infants or carriers of CF

(if + = more tests)

Chest PT for Airway Clearance should start in

Infancy (12 locations- 2 min each)

What is no longer recommend for airway clearance?

head down