1、文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Lecture Points Neonatal pulmonary function Clinical Manifestation The main causes Main types of the disease Case discussion and presentation Summary and conclusion文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Pulmonary function of the newborns in particular Relative s
2、mall capacity of the lungs：limited reserved volume poor compensation,likely to be distressedRespiratory on abdomen and diaphragmatic movement Distension:likely to be respiratory distressedpulmonary surfactant(PS)relative in small amount in preterms and easily to be deficiencyDiseased lungs trends po
3、or compliance and even ARDS文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Neonatal Respiratory DistressGeneral picture commonly occurs during neonatal period caused by various pathogeneses breath or 、irregular,apnea With or without retraction at breathing,suprasternal and intercostal usually with cyanosis m
4、ore or less 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Causation of neonatal respiratory distress Upper respiratory tract：choana,macrotongue,micrognathia Larynx/throat and trachea：intenerate pulmonary disease：inflammation、abnormality or hypogenesis others：congenital heart disease metabolic problems,CNS
5、caused文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Pathophysiology in neonatal respiratory distress hypoxic and/or hypoventilation hypoxemia,PCO2 respiration center peripheral biochemical sensors breath or 、irregular,apnea文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Neonatal Respiratory Distress Hyaline Membran
6、e Disease （HMD、RDS)Neonatal infectious Pneumonia Meconium Aspiration Syndrome(MAS)for differentiation文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Hyaline Membrane Disease（HMD/RDS）Clinical manifestation preterms normal at birth,respiratory distressed in several hours after birth progressively developing an
7、d deterioration self cured process during the sickness 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical manifestation After birth commonly seen,intrauterine infectious pneumonia relatively less seen Occurring in neonates with different GAs and ages General appearance of infection Various in severity
8、of respiratory distress Blood-gas：PaO2 、PaCO2 Neonatal infectious Pneumonia文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Meconium Aspiration Syndrome(MAS)Clinical manifestation Terms and post-terms commonly seen History of intrauterine distress amniotic fluid stained by meconium Lower Apgars score Distress
9、 occurs soon after birth Tachypnea and withdrawal at breathing Blood-gas：PaO2 ,PaCO2 and acidosis文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。CXR:HMD文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。CXR:pneumonia 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。CXR:MAS文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。CXR:MAS 文档仅供参考，不能作为
10、科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressMonitoring General appearance：T;response,skin color,feeding tolerance respiration（frequency,pattern and apnea）Other systems:HR,liver,abdomen Blood-gas,Pa O2、SaO2文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management
11、 for neonatal respiratory distressOxygen therapy Nasal tube Mask and tent Pressed facial maskAttention!fio2 O2 concentration ROP,CLD/BPD文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressMechanical ventilation Target：early intervention and early withdraw Indi
12、cation：persistent cyanosis under oxygen therapy Remarkable SaO2 PaO2 and/or PaCO2 indicated by ABG 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressMechanical ventilation Ventilation modes and parameters Continuous positive airway pressure(CPAP)：4-8 cmH2O;A
13、ssistant/control(A/C)：PIP 15-25 cmH2O；RR 25-35；I/E：1：1.5-2.5；PEEP：4-12 cmH2O Pressure support ventilation(PSV)：6-10 cmH2O High frequency oxillation ventilation:HFOV文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressMedication antibiotics penicillin:10-40 万万u/
14、kg/d ampicillin:50-75mg/kg/d cephalosporin:25-50mg/kg/d PS:80-120 mg/kg,1 to 2 dose 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressKeep the baby warm Incubator Radiator Stable room tempereture文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical management for neonatal respiratory distressClinical nutrition Feeding:Breast milk/Formulas decreasing volume feeding as needed Parenteral nutrition（T/PPN）Thanks for listening Questions please?
