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