Respiratory Distress in Newborn

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 Respiratory Distress in Newborn 

1. Tachypnoea - >60

2. Respiratory distress - Tachypnoea + Increase work of breathing
                                                            - Dilation of Ala Nasi
                                                            - Intercostal & Subcostal retractions
                                                            - Grunting

 Causes  

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.

So Intubate.


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.

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