Newborn and early childhood respiratory disorders
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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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Presentation Transcript

Childhood definitions
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)




Transition at birth
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


Pathophysiological differences
Pathophysiological Differences

  • Flexible compliant thorax

  • Low lung compliance

  • High negative intrapleural pressures during inspiration


Clinical manifestations of distress
Clinical Manifestations of Distress

  • Retractions

  • Flaring nostrils

  • Expiratory grunting

  • Apnea of prematurity

  • Persistent pulmonary hypertension of the newborn


Arterial blood gases
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


Apgar score
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


Pediatric patients
Pediatric Patients

  • Not “little adults”

  • Differences in physiology affect drug dosing

  • Requires equipment and techniques tailored to size, weight, and age


Newborn and pediatric assessment
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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