Respiratory Issues in Newborn

I. Respiratory Distress Syndrome RDS

Babies that are prematurely born and whose lungs are not completely matured may have respiratory distress syndrome (RDS). The likelihood that a newborn will develop RDS and require more oxygen and assistance breathing increases with the time of birth.

The babies’ lungs are deficient in surfactant, which results in RDS. During the first 26 weeks of pregnancy, the lungs produce a liquid called surfactant. The lungs produce more surfactant as the fetus develops.

Symptoms: 

• trouble breathing, and breathe quickly
•  shallowly, make grunting noises when they breathe,
• and have cyanosis, or blue skin, from low oxygen levels.

Diagnosis: Blood gas analysis, chest X-rays, and clinical symptoms are usually used to make the diagnosis. Because of the buildup of proteinaceous material in the air sacs, the chest X-ray may have the distinctive “ground glass” look.

Treatment: The newborn is given respiratory assistance as the main course of treatment for RDS. To enhance lung function, this might entail the use of exogenous surfactant and mechanical ventilation.

Prognosis: Most newborns with RDS weighing greater over two pounds survive and do not experience any long-term health issues or developmental delays.

 Lead to complications for long term:

• The lungs get a high-pressure delivery.
• Greater severity of illness or immaturity. RDS may be linked to inflammation that damages the brain or lungs.
• Times when there wasn’t enough oxygen reaching the brain or other organs.
• Too much oxygen.

II. Bronchopulmonary Dysplasia BPD.

Premature newborns are the main population affected by bronchopulmonary dysplasia (BPD), a chronic lung condition, particularly in those who have had extended mechanical ventilation or oxygen treatment. Babies born before 28 weeks gestation are more likely to have the disease.

Bronchopulmonary dysplasia also known as chronic lung illness in neonates and breathing insufficiently.

The Symptoms of Bronchopulmonary Dysplasia:

• Breathing difficulties may experience difficulty breathing in or out, feel as though their chests are constricted, or feel as though they are not getting enough air.
• Cyanosis is a blue discoloration on the nails, skin, or mucous membranes. It happens when there is less oxygen in the blood, which causes the skin and other affected areas to appear bluish.
• Coughing is a reflex that aids in removing foreign objects, mucus, and irritants from the throat and airways.
• Poor rate of weight gain can be concerning and suggest underlying medical conditions or dietary difficulties, particularly in young children and babies.
• Wheezing is a high-pitched singing or whistling that happens when you breathe, especially when you exhale.
• Pulling at the chest (retractions) when breathing, the muscles in the chest that are situated between the ribs and other muscles clearly contract.
• Elevated Rate of Respiration are also known as tachypnea, refers to a breathing rate that is higher than normal. Normal respiratory rates vary with age, but in adults, a typical resting range is 12 to 20 breaths per minute.

Bronchopulmonary Dysplasia of Diagnosed

A chest X-ray may be taken to examine the state of the lungs and to look for symptoms of BPD, such as hyperinflation or regions of atelectasis.

The purpose of the Blood tests is to determine the bloods carbon dioxide and oxygen concentrations.

An echocardiogram might be used to assess the anatomy and physiology of the heart.

Bronchopulmonary Dysplasia of Treated

Oxygen: To keep their blood oxygen levels at a sufficient level, infants with BPD frequently need extra oxygen.

The settings of the ventilator are changed to maximize respiratory function.

Physical Therapy To encourage the growth and strength of muscles, physical treatment may be suggested.

Nutrition Therapy the BPD babies may have trouble eating, which might affect their weight increase.

Medications:

 To treat airway inflammation, corticosteroids or other anti-inflammatory drugs may be administered sometimes.

Bronchodilators To lessen airway resistance and enhance airflow, doctors may prescribe drugs that aid in dilating the airways.

iii. Meconium Aspiratory Syndrome:

Meconium, a baby first faces that is often thick and greenish-black in color, can cause a respiratory condition called Meconium Aspiration Syndrome (MAS) in infants. When meconium enters the amniotic fluid surrounding an unborn child and is breathed into the baby lungs during or soon after delivery, the condition known as multiple birth defects (MAS) results.

Symptoms of Meconium Aspiration Syndrome 

• Rapid Breathing the baby’s respiratory rate may be elevated or he may have difficulties breathing.
• Grunting noises when breathing, the infant may make grunting sounds.
• Cyanosis Insufficient oxygenation can cause the babies skin to appear blue.
• Lethargy or problem feeding the infant may exhibit decreased activity or difficulty eating.

Diagnosis

Physical Inspection the babies general health, including heart rate, respiration rate, color, and level of activity.

An X-ray of the chest is used to find anomalies such as patches of collapsed lung tissue, or atelectasis.

Blood gas analysis in this test determines the babies’ carbon dioxide and oxygen concentrations.

Treatment

Oxygen Therapy the newborn to ensure optimal oxygenation of the blood and tissues.

Antibiotics to treat potential infection.

Mechanical ventilation the baby may require the use of a ventilator to help with breathing.

Treatment for Complications Specific therapies for illnesses including pneumonia and persistent pulmonary hypertension of the newborn (PPHN) may be used if complications arise.

Prognosis

Mild cases: Infants with less respiratory distress and mild symptoms typically have a better prognosis.

Severe cases: A more cautious prognosis may be given to newborns who exhibit severe respiratory distress, low oxygen levels, or other problems.

Associated complications: In certain situations, complications including persistent pulmonary hypertension (PPHN) may arise and worsen the prognosis.

Underlying medical conditions: The prognosis may also be affected by the newborn underlying medical disorders, such as congenital abnormalities.