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Newborn and Early Childhood Respiratory Disorders

Newborn and Early Childhood Respiratory Disorders. RT 265 Chapter 33. Childhood Definitions. Neonate Birth to 1 month (first 28 days) Infant 1 month to 1 year (some texts use until 3 rd year) Pediatric 1 year to 12 years (some texts use until 21 st year).

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Newborn and Early Childhood Respiratory Disorders

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  1. Newborn and Early Childhood Respiratory Disorders RT 265 Chapter 33

  2. Childhood Definitions • Neonate • Birth to 1 month (first 28 days) • Infant • 1 month to 1 year (some texts use until 3rd year) • Pediatric • 1 year to 12 years (some texts use until 21st year)

  3. Development of the Respiratory System

  4. Lung Growth

  5. Transition at Birth • Clear lung fluid • High transpulmonary pressures to open lungs • Breathing must be stimulated • Pulmonary vasodilation, decreased PVR • Constriction of the ductusarteriosus • Closure of umbilical blood supply closes ductusvenousus • Increased SVR • Closure of the foramen ovale

  6. Pathophysiological Differences • Flexible compliant thorax • Low lung compliance • High negative intrapleural pressures during inspiration

  7. Clinical Manifestations of Distress • Retractions • Flaring nostrils • Expiratory grunting • Apnea of prematurity • Persistent pulmonary hypertension of the newborn

  8. Arterial Blood Gases • Acute alveolar hypoventilation with hypoxemia • Acute ventilatory failure with hypoxemia • Low oxygen levels due to …… • Pulmonary shunting and venous admixture • PPHN • Infant fatigue

  9. Apgar Score • Scores: • 0-3 – severe distress • 4-6 – moderate distress • 7-10 – absence of difficulty in adjusting to extrauterine life • The 5 minute score should be higher than the 1 minute score

  10. Pediatric Patients • Not “little adults” • Differences in physiology affect drug dosing • Requires equipment and techniques tailored to size, weight, and age

  11. Newborn and Pediatric Assessment • Systematic collection of clinical data • Assessment of the data • Formulation of an appropriate treatment plan • Utilizing: • Objective data • Assessments • Treatment plans • Apgar Score

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