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Infant Respiratory Distress Syndrome (Clinical signs and symptoms…
Infant Respiratory Distress Syndrome
Etiology
underdeveloped lungs lack sufficient pulmonary surfactant
Pathophysiology
lack of surfactant increases surface tension, making the alveoli prone to collapse.
Clinical signs and symptoms
Shunting and severe hypoxemia that does not respond to oxygen
Evidence of prematurity < 37 weeks gestation, low birth weight < 1500g
Maternal diabetes
L/S ration < 2
Respiratory distress: tachypnea, inter/subcostal retractions, grunting, decreased breath sounds, nasal flaring, cyanosis at room air
Diagnostics
CRX
ABG looking for acidosis with severe hypoxemia
DIfferential diagnosis
transient tachypnea of the newborn is seen in mature infants
Cultures to rule out disease
Hyperoxia tests to rule out cardiac related causes
Echocardiogram to rule out R/L shunt (PDA)
Respiratory management
Replacement surfactant therapy
Intubation with a 2.5 or greater ETT
FiO2 to maintain PO2 50 -70 and SpO2 85 - 92%