Respiratory Distress in Newborn
1. Tachypnoea - >60
2. Respiratory distress - Tachypnoea + Increase work of breathing
- Dilation of Ala Nasi
- Intercostal & Subcostal retractions
1. Preterm : HMD (=RDS) - Most Common in preterm
2. Term :
- TTNB (Transient tachypnoea of newborn)
- MAS (Meconium aspiration syndrome)
3. Congenital : Diaphragmatic Hernia , Tracheo-oesophageal fistula
Diaphragmatic hernia - (Surgical Emergency)
- Scaphoid Abdomen
- Barrel shaped chest
- Mediastinal shift to right (in Bochdalek)
- Apparent Dextrocardia (in Bochdalek)
- Peristaltic sounds on left side (in Bochdalek)
Develops from ( for a related MCQ - Click here )
a. Septum transversum
b. Pleuroperitoneal Membrane
c. Dorsal Oesophageal mesentry
d. Body wall
e. Cervical Myotome
Types : Read More
- Bochdalek (90% cases) - Left Posterior ( Mnemonic : BPL )
- Morgagni - Right Anterior ( Mnemonic : ARM)
There is Pulmonary hypoplasia due to this and it causes distress.
Bag and Mask ventilation is Contraindicated in diaph. hernia.
Because some air goes to stomach and distends it - thus press diaph. even more.
Tracheo-oesophageal Fistula : Not Emergency
MC - Upper end blind and lower end communicate with trachea.
Sign - Nasogastric tube coils in upper end of oesophagus.
- Dribbling saliva from mouth
- Aspiration of gastric juice (Aspiration Pneumonia - This is Emergency)
Do Continuous Suction and prop the child up.