CLINICAL CASELana Mota Chagas

CLINIC Female premature newborn (27 weeks)

presents: Difficulty in breathing; Cyanosis; Cough; Tachypnea Expiratory grunting Nasal flaring

Diabetic mother.

STUDIES, EXAMINATION AND EVALUATION:

O/E: Temp. 37.5°C BP: 86/58 mmHg RF: 60/min (Normal: 30-50/min) P: 148/min Oxygen levels: around 70%

Chest X-ray CT scan

X-RAY EXAMS

PATIENT’S X-RAY NORMAL X-RAY

CT SCANS

PATIENT’S CT NORMAL CT

FINDINGS:

Diffuse granular opacities Low lung volumes

DIAGNOSIS:

SURFACTANT DEFICIENCY DISORDER

It’s a respiratory disease, common in premature newborns

The primary cause is the inadequacy of the surfactant fluid, which coats the internal walls of the lungs.

Ideally, the fetus’s lungs start making the surfactant between the 26th and the 34th week; a reason why the disorder is more common in premature infants.

The syndrome is more frequent in infants of diabetic mothers.

A BIT OF EMBRYOLOGY…

While the embryo is inside the uterus, the lungs are filled with amniotic fluid. When the newborn cries for the first time and the breathing begins, most of the fluid is reabsorbed. Once it happens, the surfactant liquid remains deposited as a thin layer on the alveolar cell membranes.

When the air gets in, with the first breath, the layer of surfactant protects the alveoli of a possible collapse.

When the baby cries, if there is no surfactant liquid, or if it’s insufficient, the alveoli may collapse.

TREATMENT:

Surfactant Replacement Therapy: To provide surfactant to the infants till they are capable of producing their own surfactant. In such situations surfactant is directly pushed into the baby’s lungs using a breathing tube.

Breathing Support and Oxygen Therapy: Often in infants with surfactant deficiency, oxygen therapy is recommended with the intention of ensuring adequate oxygenation of the various parts of the body and to assure that the essentials organs of the body function appropriately.

PROGNOSIS:

The prognosis of this lung disease is variable, depending on the severity of the disease.

But in the case of this patient, the prognosis is good and the child can have a normal life.

ANY QUESTIONS?

THANK YOU!!!