Pulmonary Hypertension: A Case Study

Infant with moderate to severe meconium aspiration syndrome will also show hypoxemia and hypercapnia in which eventually the infant may be unable to overcome airway obstruction and inflammation will likely results in respiratory failure and severe hypoxemia. Chest X-rays show patchy areas of atelectasis that are caused

This decrease in surfactant causes the infant work harder to draw air into the lungs, which leads to low oxygenation to the rest of the body’s organs. The more premature the infant, the greater the chance of developing RDS; other factors include previous baby’s with RDS, a mother with diabetes, C-section or early delivery, a fast labor, a multiple fetus pregnancy and/or any problems that would reduce or disrupt blood flow to the infant through the placenta.

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).

Respiratory distress syndrome (RDS) is a common lung disorder that mostly affects preterm infants. RDS is caused by insufficient surfactant production and structural immaturity of the lungs leading to alveolar collapse. Clinically, RDS presents soon after birth with tachypnea, nasal flaring, grunting, retractions, hypercapnia, and/or an oxygen need. The usual course is clinical worsening followed by recovery in 3 to 5 days as adequate surfactant production occurs. Research in the prevention and treatment of this disease has led to major improvements in the care of preterm infants with RDS and increased survival. However, RDS remains an important cause of morbidity and mortality especially in the most preterm infants. This chapter reviews the most current evidence-based management of RDS, including prevention, delivery room stabilization, respiratory management, and supportive care.

A total of 61 patients was identified as having meconium plug syndrome (MPS). MPS refers to a condition that can occur in newborns, where a mass of thickened meconium causes obstruction and delays passage during the first 24-48 hours of life. The condition may occur as a result of other disorders and /or for no apparent reason. Previous reports have indicated a link between MPS, Hirschsprung’s disease, magnesium tocolysis and cystic fibrosis.

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.

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).

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).

M.C. is a 4 week old Caucasian male and was assessed on 2/3/2015. M.C. was awake and crying in his mother’s arms. He appeared to be well-nourished, well developed and in distress. M.C.’s mother stated his full name and date of birth, which matched his ID band. His mother was sitting in the hospital bed holding him in her arms and attempting to comfort him. His father was laying on the couch in the room. A complete head to toe assessment was not done during this time but the following results were obtained based on a focused assessment. M.C. was on contact-droplet isolation. M.C. had a temperature of 37.2C, his blood pressure was 33/47 with a MAP of 68 taken on his left leg. His respirations were 40 breaths per minute with an oxygen saturation of 100%. His pulse was 178 beats per minute. M.C. was on room air and had a PIV located in his left hand. There was no presence of tubes or drains. Pain was not assessed at this time however, M.C. was fussy and crying. The anterior and posterior fontanels were inspected. The anterior fontanel was soft and flat. M.C.’s lung sounds were clear to auscultation. His mother reported that he had some nasal congestion but had no

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.

“Why does the use of MagSulfate increase risk of SUPC?” As you reported “guidelines must be established to ensure proper newborn monitoring occurring during skin to skin contact during the first two hours of life (Pejovic, 2013).

One of the most important determinant of fetal viability is the pulmonary system development and maturity. The prenatal awareness of any abnormalities or anomalies going to ensure better management of the pregnancy, also giving the opportunity for the medical team and parents to prepare for the delivery and postnatal treatment. Congenital malformations of the fetal thorax are common which can involve many organs. Early detection and accurate diagnosis of fetal pathology are possible by using ultrasound and MRI imaging.

The patient manifested signs of respiratory distress precipitated by a pneumonia and bronchiolitis infection. A.D was on 0.5 liters of oxygen via nasal prongs with an oxygen saturation reading of 94%. On prior days without the supplemental oxygen, she was desaturating to below 92%, “ high flow rates generate continuous positive pressure in the airways that could help reduce the work of breathing in bronchiolitis and decrease the need for more invasive respiratory support” (Casey, 2015, p. 24). The patient had a respiratory rate of 42 breaths per minute and the normal respiratory rate for a 13month old as stated in Perry et al. (2013) ranges between 20-40 breaths per minute. Also, the patient had a heart rate of 158 beats per minute and the

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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