Meconium can block the infant’s airway when aspirated, causing hypoxia. Due to the blockage of the air passages, the lungs can hyperinflate or collapse (Ward et al., 2016, p. 737). The pulmonary surfactant that allows for alveolar re- expansion is also affected by the inhalation of meconium, leading to respiratory failure. El Shahed, Dargaville, Ohlsson, & Soll (2014) pointed out that “Meconium inhibits the surface tension-lowering properties of surfactant.” MAS is the most common cause of persistent pulmonary hypertension of the newborn (PPHN). It occurs when fetal circulation remains after birth due to vascular resistance in the pulmonary system, causing failure of transition to normal adult- type circulation (Ward et al., 2016, p. 738). Systematic reviews have been conducted to test the effectiveness of the interventions of MAS, leading to better clinical outcomes. …show more content…
A low Apgar’s score is also noted due to initial respiratory distress, depending on the amount of meconium aspirated. The nurse would auscultate rales and rhonchi due to the presence of meconium obstructing the airways. With MAS, the lungs are hyperinflated with air, causing barrel- shaped chest (Ward et al., 2016, p. 737). Hyperinflation can be seen through a chest x- ray exam. In addition, “Majority of newborns with MAS develop tachypnea and mild cyanosis within 12 to 24 hours after the birth, which spontaneously disappear within 72 hours” (Mokra et al., 2010, p.
Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.
One of the main problems that occur from the maintaining of pulmonary resistance is bidirectional hemodynamic shunting at the ductus arteriosus or at the patent foramen ovale (Razzaq et al, 2013). Starting with the ductus arteriosus this duct usually closes due to the oxygen saturation increase, which leads to the lesser circulation of PGE2 which is Prostaglandin E2. PGE2 binds and activates the prostaglandin E2 receptor which leads to the duct being held open (Rang et al, 2007). Due to the lower blood flow of the PGE2 stays circulating in greater amounts and leaves the duct open which causes increased blood pressure on the vasculature of the lungs. This increased pressure doesn’t allow the blood to enter the vasculature of the lungs and shunts it back. This then results in less gas exchange than necessary for survival. Next, we need to look at the foramen ovale. It should close off at birth when the
Necrosis of the cells in the small, lower airways occurs, and mucous secretions are increased (Conquest, Cremonesini, & Neill, 2013). Because of the ciliary damage in the infants’ lungs, it is almost impossible for the secretions to be cleared. Bronchiolar level obstruction is caused by these mucosusal secretions, as is desquamation of the dead skin cells and edema (Conquest, Cremonesini, & Neill, 2013). Plugs of soughed, necrotic epithelium and fibrin in the airways will cause partial or total obstruction to airflow, making it very difficult for he infant to exhale which will consequently result in air becoming trapped and will reduce gaseous exchange (Conquest, Cremonesini, & Neill, 2013).
The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.
The list of proposed chronic abnormalities is lengthy. To this date, research has confirmed the following: 1) SIDS is due to a dysfunction of the cardiac and/or respiratory systems, and 2) the death of the infant is due to hypo-ventilation of the lungs and periods of complete cessation of breathing or apnea. Hypo-ventilation and apnea cause hypo-perfusion of the tissues with necessary oxygen. Ischemia of tissues results and eventually causes death. Research now centers around discovering the cause of infant hypo-ventilation and apnea.
Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).
Another group of patients which require challenging ventilation strategies are the preterm infants. The lungs of preterm infants have undeveloped distal airway structures, with a thick air/blood barrier and a small surface area for gas-exchange (Wallace et al., 2009). They are most likely to be surfactant deficient due to under-developed epithelial cells which lack the type II alveolar cells (Wallace et al., 2009). As a result, preterm infants often require respiratory support in the minutes following birth (Roupie et al., 1995).
The human body is a very complex organism composed of different types of systems and functions. All the functions that each system has, is what makes possible for the body to obtain life. One of the most important systems in one’s body is the circulatory system, where the heart, the lungs, and the blood vessels work together to form the circle part of the circulatory system. The pumping of the heart forces the blood on its journey. The body’s circulatory system really has three parts: pulmonary circulation, coronary circulation, and systemic circulation. Each part must be working independently in order for them to all work together. However, when one of the parts of the circulatory system does not
This study investigated the relationship between arterial partial pressure of carbon dioxide PaCO2 with different pulmonary illness and neurodevelopmental impairment in premature babies. The main variable measured was the amount of PaCo2 used going from high to low, described as Hypercapnia, Normocapnia, Hypocapnia and Fluctuators (from Hyper to Hypo) an its incidence in the Intraventricular Haemorrhage IVH.
Accordingly, to this information of COPD: Coping with COPD from PubMed Health, this article provides the early stages, progression, coping and emergency plan and this disease affects family and friends. It is written answering the question, what to expect from COPD and how to manage this lung disease? A team of health care professionals, scientists and editors, and experts (Chronic obstructive pulmonary disease (COPD), 2015), provides education of how this disease may affect daily lives, how to live with this disease and what causes
One of the many changes that affect us every day is oxygen toxicity in premature
Alyssa Ayres, author of this week’s reading, questions yet defends the rise of India as a global power. Ayres praises the country’s booming growth in military defense to manufacturing ventures. While the world continues to view India as an “emerging power,” its alliance with the United States can help set them up for the world
Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003).
Meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates in developing
The most serious of these being hyaline membrane disease (HMD), most commonly known as RDS or respiratory distress syndrome. Babies that suffer from this condition will tend to find it very difficult to breathe due to the increased surface tension and the ultimate lack of oxygen transported through the body can seriously impair and damage the functions of the brain and other organs of the baby. Surfactant deficiency’s can also sometimes be caused by mutations in a particular gene. An example of this is surfactant protein or SP-B deficiency. This particular dysfunction is hereditary and is caused by a gene mutation on chromes number two. Babies that suffer from tis condition rarely survive past a few months. However there are some procedures that can help babies who may have been born prematurely and have not manufactured enough surfactants to support regular functions. Surfactant replacement therapy and surfactant supplements are amongst the most popular treatments of these types of surfactant deficiencies in newly born