新生儿学英语课件NeoResDistres

Nonatology:NeonatalRespiratoryDistressLecturePointsNeonatalpulmonaryfunctionClinicalManifestationThemaincausesMaintypesofthediseaseCasediscussionandpresentationSummaryandconclusionPulmonaryfunctionofthenewbornsinparticularRelativesmallcapacityofthelungs：limitedreservedvolumepoorcompensation,likelytobedistressedRespiratoryonabdomenanddiaphragmaticmovementDistension:likelytoberespiratorydistressedpulmonarysurfactant(PS)relativeinsmallamountinpretermsandeasilytobedeficiencyDiseasedlungstrendspoorcomplianceandevenARDSNeonatalRespiratoryDistressGeneralpicturecommonlyoccursduringneonatalperiodcausedbyvariouspathogenesesbreathor、irregular,apneaWithorwithoutretractionatbreathing,suprasternalandintercostalusuallywithcyanosismoreorlessCausationof

neonatalrespiratorydistressUpper

respiratorytract：choana,macrotongue,micrognathiaLarynx/throatandtrachea：inteneratepulmonarydisease：inflammation、abnormalityorhypogenesisothers：congenitalheartdiseasemetabolicproblems,CNScausedPathophysiologyin

neonatalrespiratorydistresshypoxic

and/orhypoventilation

hypoxemia,PCO2

respirationcenterperipheralbiochemicalsensors

breathor、irregular,apnea

NeonatalRespiratoryDistressHyalineMembraneDisease（HMD、RDS)NeonatalinfectiousPneumoniaMeconiumAspirationSyndrome(MAS)

fordifferentiationHyalineMembraneDisease（HMD/RDS）Clinicalmanifestationpretermsnormalatbirth,respiratorydistressedinseveralhoursafterbirthprogressivelydevelopinganddeteriorationselfcuredprocessduringthesicknessClinicalmanifestationAfterbirthcommonlyseen,intrauterineinfectiouspneumoniarelativelylessseenOccurringinneonateswithdifferentGAsandagesGeneralappearanceofinfectionVariousinseverityofrespiratorydistressBlood-gas：PaO2、PaCO2NeonatalinfectiousPneumonia

MeconiumAspirationSyndrome(MAS)ClinicalmanifestationTermsandpost-termscommonlyseenHistoryofintrauterinedistressamnioticfluid

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meconiumLowerApgar’sscoreDistressoccurssoonafterbirthTachypneaandwithdrawalatbreathingBlood-gas：PaO2,PaCO2andacidosisCXR:HMDCXR:pneumoniaCXR:MASCXR:MASClinicalmanagementforneonatalrespiratorydistressMonitoringGeneralappearance：T;response,skincolor,feedingtolerancerespiration（frequency,patternandapnea）Othersystems:HR,liver,abdomenBlood-gas,PaO2、SaO2ClinicalmanagementforneonatalrespiratorydistressOxygentherapyNasaltubeMaskandtentPressedfacialmaskAttention!fio2O2concentrationROP,CLD/BPDClinicalmanagementforneonatalrespiratorydistressMechanicalventilationTarget：earlyinterventionandearlywithdrawIndication：persistentcyanosisunderoxygentherapyRemarkableSaO2PaO2and/orPaCO2

indicatedbyABG

ClinicalmanagementforneonatalrespiratorydistressMechanicalventilationVentilationmodesandparametersContinuouspositiveairwaypressure(CPAP)：4-8cmH2O;Assistant/control(A/C)：PIP15-25cmH2O；RR25-35；I/E：1：1.5-2.5；PEEP：4-12cmH2OPressuresupportventilation(PSV)：6-10cmH2OHighfrequencyoxillationventilation:HFOVClinicalmanagementforneonatalrespiratorydistressMedicationantibioticspenicillin:10-40万u/kg/dampicillin:50-75mg/kg/dcephalosporin:25-50mg/kg/dPS:80-120mg/kg,1to2doseClinicalmanagementforneonatalrespiratorydistressKeepthebabywarmIncubatorRadiatorStableroomtemperetureClinicalmanagementforneonatalresp