Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS...
-
Upload
veronica-freeman -
Category
Documents
-
view
216 -
download
0
Transcript of Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS...
![Page 1: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/1.jpg)
Respiratory Distress Respiratory Distress in in
NeonatesNeonatesDr.Mohammad Saquib Mallick, Dr.Mohammad Saquib Mallick,
FRCSFRCS Consultant Paediatric Surgeon ,Consultant Paediatric Surgeon ,
King Fahd Medical City.King Fahd Medical City.
Riyadh Riyadh
![Page 2: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/2.jpg)
Principles of Principles of Neonatal Surgery Neonatal Surgery
Types of Newborns:– Full-term: >38 weeks and weight >
2.5 kg – preterm infant: <38 weeks with
appropriate weight– SGA: >38 weeks and weight< 2.5 kg– VLBW: <32 weeks and <1.5 kg
There are physiologic differences between all these infants
![Page 3: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/3.jpg)
Respiratory DistressRespiratory Distress The newborn suspected of having
respiratory distress should be studied in a logical step by step manner.
It is important to establish that the infant has a surgical problem before surgery is performed.
Resuscitation must be done before operation
Every condition will be dealt Every condition will be dealt accordinglyaccordingly
![Page 4: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/4.jpg)
Respiratory DistressRespiratory Distress
Causes– Surgical
Upper airway obstruction Congenital diaphragmatic hernia Eventration of Diaphragm Esophageal atresia with TOF Pneumothorax Congenital lobar emphysema Congenital cystic adenomatoid
malformation Pulmonary Sequestration
![Page 5: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/5.jpg)
Respiratory DistressRespiratory Distress
Congenital Diaphragmatic HerniaCongenital Diaphragmatic Hernia
Incidence: 1:2000 to 5000,
female more affected,
prematurity and low BW,
Left side
![Page 6: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/6.jpg)
Diaphragmatic Diaphragmatic HerniaHernia
SymptomsNone to severePolyhydramniosPresents birth to after many days
SignsScaphoid abdomenAudible bowel sound in the chest
![Page 7: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/7.jpg)
Diaphragmatic Diaphragmatic HerniaHernia
Diagnosis:– Prenatal <25wks, prognosis
bad– Clinical– CXR– 10% >after neonatal period
![Page 8: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/8.jpg)
Diaphragmatic Diaphragmatic HerniaHernia
![Page 9: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/9.jpg)
Diaphragmatic Diaphragmatic HerniaHernia
Management– Reussciataion and
stabilization– Laparotomy
Primary Patch by silo or
muscle– Laparoscopic repair
![Page 10: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/10.jpg)
Eventration of Eventration of DiaphragmDiaphragm
Def: Abnormal elevation of diaphragm Def: Abnormal elevation of diaphragm that results in paradoxical motion of that results in paradoxical motion of affected hemidiaphragm during affected hemidiaphragm during inspiration and expirationinspiration and expiration
Cause:Cause:– Congenital Congenital – AcquiredAcquired
Symptoms: Symptoms: – NoneNone– Resp. distressResp. distress– Wheezing, repeated URI, Wheezing, repeated URI,
![Page 11: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/11.jpg)
Eventration of Eventration of DiaphragmDiaphragm
Diagnosis:Diagnosis:– CXRCXR– Fluoroscopy or Fluoroscopy or – Real time USReal time US
![Page 12: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/12.jpg)
Eventration of Eventration of DiaphragmDiaphragm
Management:Management:–ConservativeConservative–plicationplication
![Page 13: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/13.jpg)
Oesophageal atresia & TOFOesophageal atresia & TOF Incidence: 1: 5000 Incidence: 1: 5000 live births, 50% associated with live births, 50% associated with
anomaliesanomalies
Types: Types:
Symptoms and Signs:Symptoms and Signs:– Excessive salivation Excessive salivation – Respiratory DistressRespiratory Distress– Inability to pass NG tubeInability to pass NG tube– Choking and coughing on feedingChoking and coughing on feeding
VACTERLSyndrome
![Page 14: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/14.jpg)
Oesophageal Oesophageal atresia & TOFatresia & TOF
Diagnosis Diagnosis – Clinical & CXR – Clinical & CXR Management: Management: ResuscitationResuscitation
– Common typeCommon type Right thoracotomyRight thoracotomy
Division and repair of TOFDivision and repair of TOF Primary anastomosisPrimary anastomosis
– Pure TOFPure TOF Division and repairDivision and repair
– Isolated atresiaIsolated atresia >3 vertebra>3 vertebra
Staged surgery (gastrostomy and Staged surgery (gastrostomy and followed in 3-6 months by delayed followed in 3-6 months by delayed repair. If fails then need esophageal repair. If fails then need esophageal replacement (stomach or colon)replacement (stomach or colon)
![Page 15: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/15.jpg)
![Page 16: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/16.jpg)
Respiratory DistressRespiratory Distress
Pneumothorax: The collection of air in the
pleural cavity in neonates.Causes: Hyaline membrane disease Meconium aspiration Pulmonary hemorrhage
Traumatic Rupture of cong.lung cyst
![Page 17: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/17.jpg)
Respiratory DistressRespiratory Distress
Diagnosis: Clinical
Radiological
![Page 18: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/18.jpg)
Respiratory DistressRespiratory Distress
![Page 19: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/19.jpg)
Respiratory DistressRespiratory Distress Treatment: 1, Decompression by inserting chest tube
2, Treat the cause
![Page 20: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/20.jpg)
Respiratory DistressRespiratory Distress
Congenital Lobar Emphysema:
“ massive over distension of a lobe or a segment of the lung that causes compression of normal lungs and medistinum“
![Page 21: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/21.jpg)
Respiratory DistressRespiratory Distress
Etiology; air trapping due to abnormalities in
the bronchial cartilages.
bronchial cartilage may be
absent, hypoplastic, or dysplastic
![Page 22: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/22.jpg)
Respiratory DistressRespiratory Distress
X-rays
![Page 23: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/23.jpg)
Respiratory DistressRespiratory Distress CT Scan:
![Page 24: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/24.jpg)
Respiratory DistressRespiratory Distress
Management:
Surgical excision of of the involved lobe or lobes is the treatment of choice.
![Page 25: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/25.jpg)
![Page 26: Respiratory Distress in Neonates Respiratory Distress in Neonates Dr.Mohammad Saquib Mallick, FRCS Consultant Paediatric Surgeon, Consultant Paediatric.](https://reader034.fdocuments.us/reader034/viewer/2022051401/56649ec65503460f94bd1f16/html5/thumbnails/26.jpg)
QUESTIONS ?QUESTIONS ?