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Nonatology:NeonatalRespiratoryDistressNonatology:1LecturePointsNeonatalpulmonaryfunctionClinicalManifestationThemaincausesMaintypesofthediseaseCasediscussionandpresentationSummaryandconclusionLecturePointsNeonatalpulmon2PulmonaryfunctionofthenewbornsinparticularRelativesmallcapacityofthelungs：limitedreservedvolumepoorcompensation,likelytobedistressedRespiratoryonabdomenanddiaphragmaticmovementDistension:likelytoberespiratorydistressedpulmonarysurfactant(PS)relativeinsmallamountinpretermsandeasilytobedeficiencyDiseasedlungstrendspoorcomplianceandevenARDSPulmonaryfunctionofthenewb3NeonatalRespiratoryDistressGeneralpicturecommonlyoccursduringneonatalperiodcausedbyvariouspathogenesesbreathor、irregular,apneaWithorwithoutretractionatbreathing,suprasternalandintercostalusuallywithcyanosismoreorlessNeonatalRespiratoryDistressG4Causationof
neonatalrespiratorydistressUpper
respiratorytract：choana,macrotongue,micrognathiaLarynx/throatandtrachea：inteneratepulmonarydisease：inflamation、abnormalityorhypogenesisothers：congenitalheartdiseasemetabolicproblems,CNScausedCausationof
neonatalrespira5Pathophysiologyin
neonatalrespiratorydistresshypoxic
and/orhypoventilation
hypoxemia,PCO2
respirationcenterperipheralbiochemicalsensors
breathor、irregular,apneaPathophysiologyin
neonatalr6
NeonatalRespiratoryDistressHyalineMembraneDisease（HMD、RDS)NeonatalinfectiousPneumoniaMeconiumAspirationSyndrome(MAS)
fordifferentiationNeonatalRespiratoryDistress7HyalineMembraneDisease（HMD/RDS）Clinicalmanifestationpretermsnormalatbirth,respiratorydistressedinseveralhoursafterbirthprogressivelydevelopinganddeteriorationselfcuredprocessduringthesicknessHyalineMembraneDisease（HMD/R8ClinicalmanifestationAfterbirthcommonlyseen,intrauterineinfectiouspneumoniarelativelylessseenOccurringinneonateswithdifferentGAsandagesGeneralappearanceofinfectionVariousinseverityofrespiratorydistressBlood-gas：PaO2、PaCO2NeonatalinfectiousPneumoniaClinicalmanifestationNeonata9
MeconiumAspirationSyndrome(MAS)ClinicalmanifestationTermsandpost-termscommonlyseenHistoryofintrauterinedistressamnioticfluid
stainedby
meconiumLowerApgar’sscoreDistressoccurssoonafterbirthTachypneaandwithdrawalatbreathingBlood-gas：PaO2,PaCO2andacidosisMeconiumAspirationSyndrome10CXR:HMDCXR:HMD11CXR:pneumoniaCXR:pneumonia12CXR:MASCXR:MAS13CXR:MASCXR:MAS14ClinicalmanagementforneonatalrespiratorydistressMonitoringGeneralappearance：T;response,skincolor,feedingtolerancerespiration（frequency,patternandapnea）Othersystems:HR,liver,abdomenBlood-gas,PaO2、SaO2Clinicalmanagementforneonat15ClinicalmanagementforneonatalrespiratorydistressOxygentherapyNasaltubeMaskandtentPressedfacialmaskAttention!fio2O2concentrationROP,CLD/BPDClinicalmanagementforneonat16ClinicalmanagementforneonatalrespiratorydistressMechanicalventilationTarget：earlyinterventionandearlywithdrawIndication：persistentcyanosisunderoxygentherapyRemarkableSaO2PaO2and/orPaCO2
indicatedbyABG
Clinicalmanagementforneonat17ClinicalmanagementforneonatalrespiratorydistressMechanicalventilationVentilationmodesandparametersContinuouspositiveairwaypressure(CPAP)：4-8cmH2O;Assistant/control(A/C)：PIP15-25cmH2O；RR25-35；I/E：1：1.5-2.5；PEEP：4-12cmH2OPressuresupportventilation(PSV)：6-10cmH2OHighfrequencyoxillationventilation:HFOVClinicalmanagementforneonat18ClinicalmanagementforneonatalrespiratorydistressMedicationantibioticspenicillin:10-40萬u/kg/dampicillin:50-75mg/kg/dcephalosporin:25-50mg/kg/dPS:80-120mg/kg,1to2doseClinicalmanagementforneonat19ClinicalmanagementforneonatalrespiratorydistressKeepthebabywarmIncubatorRadiatorStableroomtemperetureClinicalmanagementforneonat20ClinicalmanagementforneonatalrespiratorydistressClinicalnutritionFeeding:
Breastmilk/FormulasdecreasingvolumefeedingasneededParenteralnutrition（T/PPN）Clinicalmanagementforneonat21ThanksforlisteningQuestionsplease?ThanksforlisteningQuestions22Nonatology:NeonatalRespiratoryDistressNonatology:23LecturePointsNeonatalpulmonaryfunctionClinicalManifestationThemaincausesMaintypesofthediseaseCasediscussionandpresentationSummaryandconclusionLecturePointsNeonatalpulmon24PulmonaryfunctionofthenewbornsinparticularRelativesmallcapacityofthelungs：limitedreservedvolumepoorcompensation,likelytobedistressedRespiratoryonabdomenanddiaphragmaticmovementDistension:likelytoberespiratorydistressedpulmonarysurfactant(PS)relativeinsmallamountinpretermsandeasilytobedeficiencyDiseasedlungstrendspoorcomplianceandevenARDSPulmonaryfunctionofthenewb25NeonatalRespiratoryDistressGeneralpicturecommonlyoccursduringneonatalperiodcausedbyvariouspathogenesesbreathor、irregular,apneaWithorwithoutretractionatbreathing,suprasternalandintercostalusuallywithcyanosismoreorlessNeonatalRespiratoryDistressG26Causationof
neonatalrespiratorydistressUpper
respiratorytract：choana,macrotongue,micrognathiaLarynx/throatandtrachea：inteneratepulmonarydisease：inflamation、abnormalityorhypogenesisothers：congenitalheartdiseasemetabolicproblems,CNScausedCausationof
neonatalrespira27Pathophysiologyin
neonatalrespiratorydistresshypoxic
and/orhypoventilation
hypoxemia,PCO2
respirationcenterperipheralbiochemicalsensors
breathor、irregular,apneaPathophysiologyin
neonatalr28
NeonatalRespiratoryDistressHyalineMembraneDisease（HMD、RDS)NeonatalinfectiousPneumoniaMeconiumAspirationSyndrome(MAS)
fordifferentiationNeonatalRespiratoryDistress29HyalineMembraneDisease（HMD/RDS）Clinicalmanifestationpretermsnormalatbirth,respiratorydistressedinseveralhoursafterbirthprogressivelydevelopinganddeteriorationselfcuredprocessduringthesicknessHyalineMembraneDisease（HMD/R30ClinicalmanifestationAfterbirthcommonlyseen,intrauterineinfectiouspneumoniarelativelylessseenOccurringinneonateswithdifferentGAsandagesGeneralappearanceofinfectionVariousinseverityofrespiratorydistressBlood-gas：PaO2、PaCO2NeonatalinfectiousPneumoniaClinicalmanifestationNeonata31
MeconiumAspirationSyndrome(MAS)ClinicalmanifestationTermsandpost-termscommonlyseenHistoryofintrauterinedistressamnioticfluid
stainedby
meconiumLowerApgar’sscoreDistressoccurssoonafterbirthTachypneaandwithdrawalatbreathingBlood-gas：PaO2,PaCO2andacidosisMeconiumAspirationSyndrome32CXR:HMDCXR:HMD33CXR:pneumoniaCXR:pneumonia34CXR:MASCXR:MAS35CXR:MASCXR:MAS36ClinicalmanagementforneonatalrespiratorydistressMonitoringGeneralappearance：T;response,skincolor,feedingtolerancerespiration（frequency,patternandapnea）Othersystems:HR,liver,abdomenBlood-gas,PaO2、SaO2Clinicalmanagementforneonat37ClinicalmanagementforneonatalrespiratorydistressOxygentherapyNasaltubeMaskandtentPressedfacialmaskAttention!fio2O2concentrationROP,CLD/BPDClinicalmanagementforneonat38ClinicalmanagementforneonatalrespiratorydistressMechanicalventilationTarget：earlyinterventionandearlywithdrawIndication：persistentcyanosisunderoxygentherapyRemarkableSaO2PaO2and/orPaCO2
indicatedbyABG
Clinicalmanagementforneonat39ClinicalmanagementforneonatalrespiratorydistressMechanicalventilationVentilationmodesandparametersContinuouspositiveairwaypressure(CPAP)：4-
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