单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Nonatology:,Neonatal Respiratory Distress,Lecture Points,Neonatal pulmonary function,Clinical Manifestation,The main causes,Main types of the disease,Case discussion and presentation,Summary and conclusion,Pulmonary function of the newborns in particular,Relative small capacity of the lungs：,limited reserved volume,poor compensation,likely to be distressed,Respiratory on abdomen and diaphragmatic movement,Distension,:likely to be,respiratory,distressed,pulmonary surfactant(PS)relative in small amount in preterms and easily to be deficiency,Diseased lungs trends poor compliance and even ARDS,Neonatal Respiratory Distress,General picture,commonly occurs during neonatal period caused by various pathogeneses,breath,or、irregular,apnea,With or without retraction at breathing,suprasternal and intercostal,usually with cyanosis more or less,Causation of,neonatal respiratory distress,Upper,respiratory tract：,choana,macro,tongue,micrognathia,Larynx/throat and trachea,：,intenerate,pulmonary disease：,inflammation、abnormality,or hypogenesis,others：congenital heart disease,metabolic problems,CNS caused,Pathophysiology in n,eonatal respiratory distress,hypoxic,and/or hypoventilation,hypoxemia,PCO,2,respiration center,peripheral biochemical sensors,breath,or,、irregular,apnea,Neonatal Respiratory Distress,Hyaline Membrane Disease,（HMD、RDS),Neonatal infectious Pneumonia,Meconium Aspiration Syndrome(MAS),for differentiation,Hyaline Membrane Disease（HMD/RDS）,Clinical manifestation,preterms,normal at birth,respiratory distressed in several hours after birth,progressively developing and deterioration,self cured process during the sickness,Clinical manifestation,After birth commonly seen,intrauterine infectious pneumonia relatively less seen,Occurring in neonates with different GAs and ages,General appearance of infection,Various in severity of,respiratory,distress,Blood-gas：PaO,2,、PaCO,2,Neonatal infectious Pneumonia,Meconium Aspiration Syndrome(MAS),Clinical manifestation,Terms and post-terms commonly seen,History of intrauterine distress,amniotic fluid,stained by,meconium,Lower Apgars score,Distress occurs soon after birth,Tachypnea and withdrawal at breathing,Blood-gas：PaO2,PaCO2,and acidosis,CXR:HMD,CXR:pneumonia,CXR:MAS,CXR:MAS,Clinical management for neonatal,respiratory,distress,Monitoring,General appearance：T;response,skin color,feeding tolerance,respiration（frequency,pattern and apnea）,Other systems:HR,liver,abdomen,Blood-gas,Pa O,2、,Sa,O,2,Clinical management for neonatal,respiratory,distress,Oxygen therapy,Nasal tube,Mask and tent,Pressed facial mask,Attention!fio,2,O,2,concentration,ROP,CLD/BPD,Clinical management for neonatal,respiratory,distress,Mechanical ventilation,Target：early intervention and early withdraw,Indication：,persistent cyanosis under oxygen therapy,Remarkable Sa,O,2,PaO,2,and/or PaCO,2,indicated by ABG,Clinical management for neonatal,respiratory,distress,Mechanical ventilation,Ventilation modes and parameters,Continuous positive airway pressure(CPAP)：,4,-8 cmH2O;,Assistant/control(A/C)：,PIP 15-25 cmH,2,O；RR 25-35；,I/E：1：1.5-2.5；PEEP：,4,-12 cmH,2,O,Pressure support ventilation(PSV)：6-10 cmH,2,O,High frequency oxillation ventilation:HFOV,Clinical management for neonatal,respiratory,distress,Medication,antibiotics,penicillin:10-40 万,u/kg/d,ampicillin:50-75mg/kg/d,cephalosporin:25-50mg/kg/d,PS:80-120 mg/kg,1 to 2 dose,Clinical management for neonatal,respiratory,distress,Keep the baby warm,Incubator,Radiator,Stable room tempereture,Clinical management for neonatal,respiratory,distress,Clinical nutrition,Feeding:,Breast milk/Formulas,decreasing volume,feeding as needed,Parenteral nutrition（T/PPN）,Thanks for listening,Questions please?,