Newborn and Early Childhood

Respiratory DisordersRT 265

Chapter 33

Childhood Definitions Neonate

Birth to 1 month (first 28 days)

Infant 1 month to 1 year (some texts use until 3rd

year)

Pediatric 1 year to 12 years (some texts use until 21st

year)

Development of the Respiratory System

Lung Growth

Transition at Birth Clear lung fluid

High transpulmonary pressures to open lungs

Breathing must be stimulated

Pulmonary vasodilation, decreased PVR

Constriction of the ductus arteriosus

Closure of umbilical blood supply closes ductus venousus

Increased SVR

Closure of the foramen ovale

Pathophysiological Differences

Flexible compliant thorax

Low lung compliance

High negative intrapleural pressures during inspiration

Clinical Manifestations of

Distress Retractions

Flaring nostrils

Expiratory grunting

Apnea of prematurity

Persistent pulmonary hypertension of the newborn

Arterial Blood Gases Acute alveolar hypoventilation with

hypoxemia

Acute ventilatory failure with hypoxemia

Low oxygen levels due to …… Pulmonary shunting and venous admixture

PPHN

Infant fatigue

Apgar Score Scores:

0-3 – severe distress

4-6 – moderate distress

7-10 – absence of difficulty in adjusting to extrauterine life

The 5 minute score should be higher than the 1 minute score

Pediatric Patients Not “little adults”

Differences in physiology affect drug dosing

Requires equipment and techniques tailored to size, weight, and age

Newborn and Pediatric Assessment

Systematic collection of clinical data

Assessment of the data

Formulation of an appropriate treatment plan

Utilizing: Objective data

Assessments

Treatment plans

Apgar Score