W2 New

• the 3 important surfactant that must be present at birth: lethicin/sphingomyelin, phosphatidylcholine, phosphatidylglycerol
• the normal ratio of lecithin/sphingomyelin is 2:1
• pancuronium is a muscle relaxant used as an additional therapy for RDS
• nitric oxide causes vasodilation
• extracorporeal membrane oxygenation (ECMO)
• normal pH level range: 7.35-7.45
• normal pO2: 80-100 mmHg
• normal pCO2: 35-45 mmHg
• these are the at-risk newborns for RDS: CS, diabetic mother, decreased blood perfusion in lungs, and preterm
• normal O2 saturation: 94-100%
• cause of RDS: low/absent surfactant level
• RDS Diagnostic Test: Blood Glucose is for hypoglycemia
• RDS Diagnostic Test: Serum Calcium is for hypercalcemia
• RDS Diagnostic Test: ABG is for respiratory acidosis
• RDS additional factors: hypoxia, hyperbilirubinemia, retrolental fibroplasia, bronchopulmonary dysplasia (BPD), patent ductus arteriosus
• CPAP means Continues Patent Airway Pressure
• MAP means Mean Airway Pressure
• PEEP means Post End-Expiratory Pressure
• SIMV means Synchronized Intermittent Mandatory Ventilation
• S/Sx of RDS: low BP, nasal flaring, tachypnea, cyanotic mucous membrane, grunting, sternal/subcostal retractions, respiratory acidosis, (seesaw respiration, pneumothorax)
• RDS Med: Indomethacin is for ductus arteriosus closure
• RDS Med: sodium bicarbonate is for respiratory acidosis
• RDS Med: Betamethasone is a glucocorticosteroid given to mothers to prevent RDS
• Time to give Betamethasone: 12-24 hours after birth; 24-34 weeks pregnancy
• RDS Med: Celestone is a glucocorticoid and an artificial surfactant for NBs w/ RDS
• Normal oxygen concentration in RDS: <40%
• In a NB w/ RDS, when should you increase the O2 pressure to keep the airway open?

  First 72 hours or 1-3 days
• In a NB w/ RDS, when should you decrease the O2 pressure?

  After 72 hours or 4th day
• RR of a newborn w/ TTN: 80-120 breaths/min
• At birth, the normal RR of a NB goes up to 80 breaths/min. After an hour, it decreases to 30-60 breaths/min.
• S/Sx of TTN: tiring effort of breathing, mild retractions, mild hypoxia and hypercapnia, cannot suck and breath simultaneously, presence of fluid in the central lung
• TTN Causes: slow lung fluid absorption and decrease in production of phosphatidylglycerol
• Occurence of TTN in which infants: CS, mom received extensive fluid during labor, preterm
• TTN means Transient Tachypnea of the Newborn
• Peak hours of TTN: 36 hours
• When do TTN fade?

  after 72 hours
• MAS stands for Meconium Aspiration Syndrome
• Meconium is already present as early as 10 weeks gestation
• Color of meconium: green to greenish black
• Meconium aspiration in utero can cause chemical pneumonitis