Overview. Transient Tachypnea of the Newborn. Why discussing TTN? Questions? Questions? Case
|
|
- Jerome Jones
- 7 years ago
- Views:
Transcription
1 Transient Tachypnea of the Newborn CMNRP Feb 29,2012 Prakash K Loganathan (Fellow- Neonates) Overview TTN- pathogenesis, clinical findings, radiology, management. Overview of common conditions causing respiratory distress in newborn. Supervisor: Dr Jana Feberova Why discussing TTN? TTN is very common and is a frustrating condition that -sometimes requires transfer of the baby -separation from the mother if she cannot be transferred, -multiple diagnostic studies, - delay in discharge -increased healthcare costs and -occasionally associated with complications. Case As a nurse working in a small nursery, where the paediatrician is not in house: -32 yr old G3 L2 mother, -Serologies all were protective & No maternal fever. -Antenatal USS: normal. -Baby boy was delivered by elective C-section (Ind: repeat C-section). -APGAR of 9(1 ),9(5 ). -He developed respiratory distress within 1hr of birth. Questions? What is your differential diagnosis? What is your next step? How will you monitor the baby? Will you do any investigations at this point? What will you do if the baby continued to have respiratory distress? Questions? What investigations will you do at this point? What treatment will you give as the initial measure? When should tertiary care center/ neonatologist be consulted? 1
2 Why do need fluid in the lungs? (During fetal life) (1) During fetal life, fluid is secreted into the alveoli to maintain normal lung growth and function, (2) fetal lung volume approximates the functional residual capacity that would be established once air breathing is initiated. How the lung fluid is Cleared? Decreased lung Fluid production prior to spontaneous vaginal delivery. Onset of labor: the high circulating concentration of epinephrine activates the switch within the lungs from net secretion to net reabsorption. Vaginal squeeze of the thorax contribute to a very small proportion of lung fluid resorption. Epidemiology 3.6 to 5.7 per 1,000 term infants. Retention of fetal lung fluid may be more common in preterm infants (up to 10 per 1,000births). Late preterm delivery increases the risk for TTN Risk factors for TTN cesarean section with or without labor, male sex, family history of asthma (especially in mother), lower gestational age, macrosomia, maternal diabetes. Mode of delivery & TTN Vaginal delivery is protective. C-section increases the risk. Labor before C-section may not provide sufficient protection. Arch Gynecol Obstet Amer Jo of Perinatology
3 SPECTRUM RETAINED LUNG FLUID TRANSITION TTN COMPLICATIONS 2 TO 12HRS Clinical Features Cxray - TTN Tachypnea, retractions, nasal flaring. Grunting is common. Barrel shaped chest due to hyperinflation, which may push down the liver and spleen, making it palpable. Auscultation: crackles. Diagnosis-By exclusion (Don t assume its TTN) Prominent perihilar vascular markings due to engorged periarterial lymphatics Edema of the interlobar septae Fluid in the fissures Some degree of hyperinflation Fluid in the fissure 3
4 Management of TTN Because it is difficult to exclude pneumonia at presentation, many babies who have TTN are treated with antibiotics for the first 24 to 48 hours until the blood culture is negative, along with improved clinical status. SUPPORTIVE - keep NPO, may require IV fluids. - Cxray: performed to support the diagnosis of TTN and rule out other conditions - Gas, CBC, Diff, Blood c/s and consider antibiotics. Management of TTN - Oxygen support, CPAP or ventilatory support if needed. - Keep saturation in normal range for the gestational age. - Consider transfer to higher center based on the clinical situation. Complications Pulmonary hypertension with right-to-left shunting. Severe hypoxemia and may require high concentrations of oxygen Air leaks (rare). Experimental therapies Furosemide (systemic, Nebs) and epinephrine (nebs). Fluid restriction was shown to have some success. All these treatment options were from small studies & experimental. Currently recommended management is supportive. Differential Diagnosis: TRACHEA 4
5 PPHN PPHN usually occurs in :term infants, (less common in late preterm & post term). Abnormal persistence of elevated pulmonary vascular resistance (PVR) -- right-to-left shunting--hypoxemia. PPHN :severe cyanosis, tachypnea, and systolic murmur (tricuspid insufficiency). PPHN The appearance of the chest radiograph in PPHN will be consistent with underlying lung disease. Echocardiography is required to confirm the diagnosis of PPHN and differentiate it from structural cyanotic heart disease. RDS RDS is primarily a disease of preterm infants, some near-term infants may be affected. Surfactant deficiency that leads to alveolar collapse and diffuse atelectasis. Risk factors for RDS Preterm, Maternal diabetes, Multiple birth, Cesarean section prior to the onset of labor, Perinatal asphyxia, Cold stress. Infants whose siblings suffered from RDS. Low lung volumes Chest Xray: RDS Diffuse, reticulogranular, ground glass appearance Air bronchograms 5
6 MAS Defined as respiratory distress in an infant born through meconium-stained amniotic fluid whose symptoms cannot otherwise be explained. 13% of all live births are meconiumstained amniotic fluid, and of these, 4% to 5% of infants develop MAS. More Common In Post Term. Diagnosis of MAS Meconium-stained infant, respiratory distress, and characteristic radiographic features. The chest appears barrel-shaped (increase anterior-posterior diameter) due to over-inflation. Streaky, linear densities. Hyperinflation. Alternating diffuse patchy densities. Cxray-MAS Management of MAS Aim: to prevent development of PPHN. Treatment is mainly supportive :includes IV fluids, oxygen therapy, ventilatory support, and antibiotics. Surfactant treatment reduces the need for ECMO and may reduce the risk for pneumothorax. Pneumonia Pneumonia : in utero, during delivery (or perinatally), or postnatally. It may be classified as either early- (7 d of age) or late onset (7 d of age). At autopsies of both stillbirths and live-born neonatal deaths, pneumonia was found to be present in 20% to 60% in different centers. Intrauterine infection :rubella, cytomegalovirus, herpes simplex virus, human immunodeficiency virus. 6
7 Pneumonia Pneumonias (acquired): GBS, E.coli, Klebsiella & C.trachomatis. Pneumonias acquired after birth :respiratory viruses, streptococci or Staphylococcus aureus, and Gram neg bacteria. Management: oxygen therapy, ventilatory support, antibiotics, and other supportive measures. Radiological features of Different conditions Air bronchograms Diffuse parenchymal infiltrates TTN Radiological features of Different conditions Reticular granular pattern Loss of lung volume Fluid accumulations in interlobar spaces TTN Pulmonary lymphangiectasia Lobar consolidation Patchy areas alternating with emphysema Pneumonia Lobar sequestration CCAM Hyperinflation Pneumothorax/pneumomediastinum TTN Spontaneous THANK YOU 7
Evaluation and treatment of emphysema in a preterm infant
ISPUB.COM The Internet Journal of Pediatrics and Neonatology Volume 11 Number 1 Evaluation and treatment of emphysema in a preterm infant T Saad, P Chess, W Pegoli, P Katzman Citation T Saad, P Chess,
More informationWhy is prematurity a concern?
Prematurity What is prematurity? A baby born before 37 weeks of pregnancy is considered premature. Approximately 12% of all babies are born prematurely. Terms that refer to premature babies are preterm
More informationOET: Listening Part A: Influenza
Listening Test Part B Time allowed: 23 minutes In this part, you will hear a talk on critical illnesses due to A/H1N1 influenza in pregnant and postpartum women, given by a medical researcher. You will
More informationCongenital Diaphragmatic Hernia. Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate
Congenital Diaphragmatic Hernia Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate Congenital Diaphragmatic Hernias Incidence 1 in 2000 to 5000 live births. 80% in the left side, 20%
More informationNeonatal Emergencies. Care of the Neonate. Care of the Neonate. Care of the Neonate. Student Objectives. Student Objectives continued.
Student Objectives Neonatal Emergencies After completing this section the student will be able to: 1. Identify three physiologic and/or anatomic features unique to the newborn 2. List three perinatal factors
More informationRecurrent or Persistent Pneumonia
Recurrent or Persistent Pneumonia Lower Respiratory Tract Dr T Avenant Recurrent or Persistent Pneumonia Definitions Recurrent pneumonia more than two episodes of pneumonia in 18 months Persistent pneumonia
More information35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions.
What is Group B Strep (GBS)? Group B Streptococcus (GBS) is a type of bacteria that is found in the lower intestine of 10-35% of all healthy adults and in the vagina and/or lower intestine of 10-35% of
More informationQuality of Birth Certificate Data. Daniela Nitcheva, PhD Division of Biostatistics PHSIS
Quality of Birth Certificate Data Daniela Nitcheva, PhD Division of Biostatistics PHSIS Data Quality SC State Law requires that you file the birth certificate within 5 days of a child s birth. Data needs
More informationInfluenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus:
Respiratory Disorders Bio 375 Pathophysiology General Manifestations of Respiratory Disease Sneezing is a reflex response to irritation in the upper respiratory tract and is associated with inflammation
More informationAddendum to the NRP Provider Textbook 6 th Edition Recommendations for specific modifications in the Canadian context
Addendum to the NRP Provider Textbook 6 th Edition Recommendations for specific modifications in the Canadian context A subcommittee of the Canadian Neonatal Resuscitation Program (NRP) Steering Committee
More informationCommon Conditions, Concerns, and Equipment in the NICU
Common Conditions, Concerns, and Equipment in the NICU Babies in the NICU are carefully monitored because of their health risk. While the following is a comprehensive list of common conditions found in
More informationPediatric Respiratory System: Basic Anatomy & Physiology. Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City
Pediatric Respiratory System: Basic Anatomy & Physiology Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City Outline Introduction Developmental Anatomy Developmental Mechanics of Breathing
More informationMECHINICAL VENTILATION S. Kache, MD
MECHINICAL VENTILATION S. Kache, MD Spontaneous respiration vs. Mechanical ventilation Natural spontaneous ventilation occurs when the respiratory muscles, diaphragm and intercostal muscles pull on the
More informationCord Blood Erythropoietin and Markers of Fetal Hypoxia
July 21, 2011 By NeedsFixing [1] To investigating the relationship between cord blood erythropoietin and clinical markers of fetal hypoxia. Abstract Objective: To investigating the relationship between
More informationPulmonary Patterns VMA 976
Pulmonary Patterns VMA 976 PULMONARY PATTERNS Which pulmonary patterns are commonly described in veterinary medicine? PULMONARY PATTERNS Normal Alveolar Interstitial Structured/Nodular Unstructured Bronchial
More informationRespiratory Distress Syndrome of the Newborn
19 Respiratory Distress Syndrome of the Newborn Respiratory distress syndrome (RDS) of the newborn, also known as hyaline membrane disease, is a breathing disorder of premature babies. In healthy infants,
More informationThe Fetal Treatment Program
CONGENITAL LUNG LESIONS* The Fetal Treatment Program *This information is intended to supplement your consultation with members of the Fetal Treatment Program regarding your unborn child with a suspected
More informationMore detailed background information and references can be found at the end of this guideline
Neonatal Intensive Care Unit Clinical Guideline Oxygen Over the past few years there have been significant changes, based on high quality research, in our understanding of how to give the right amount
More informationThe clinical presentation of respiratory
Respiratory Distress in the Newborn CHRISTIAN L. HERMANSEN, MD, and KEVIN N. LORAH, MD Lancaster General Hospital, Lancaster, Pennsylvania The most common etiology of neonatal respiratory distress is transient
More informationObjectives COPD. Chronic Obstructive Pulmonary Disease (COPD) 4/19/2011
Objectives Discuss assessment findings and treatment for: Chronic Obstructive Pulmonary Disease Bronchitis Emphysema Asthma Anaphylaxis Other respiratory issues Provide some definitions Chronic Obstructive
More informationCardiovascular Disease and Maternal Mortality what do we know and what are the key questions?
Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? AFSHAN HAMEED, MD, FACOG, FACC Associate Clinical Professor Maternal Fetal Medicine and Cardiology University
More informationMaternity Care Primary C-Section Rate Specifications 2014 (07/01/2013 to 06/30/2014 Dates of Service)
Summary of Changes Denominator Changes: Two additions were made to the denominator criteria. The denominator was changed to include patients who had: a vertex position delivery AND a term pregnancy of
More informationAHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings
AHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings Resuscitation step Recommendations (2005) Recommendations (2010) Comments/LOE
More informationRural Health Advisory Committee s Rural Obstetric Services Work Group
Rural Health Advisory Committee s Rural Obstetric Services Work Group March 15 th webinar topic: Rural Obstetric Patient and Community Issues Audio: 888-742-5095, conference code 6054760826 Rural Obstetric
More informationA8b. Resuscitation of a Term Infant with Meconium Staining. Session Summary. Session Objectives. References
A8b Resuscitation of a Term Infant with Meconium Staining Karen Wright, PhD, NNP-BC Assistant Professor and Coordinator, Neonatal Nurse Practitioner Program Dept. of Women, Children, and Family Nursing,
More informationCystic Fibrosis. Cystic fibrosis affects various systems in children and young adults, including the following:
Cystic Fibrosis What is cystic fibrosis? Cystic fibrosis (CF) is an inherited disease characterized by an abnormality in the glands that produce sweat and mucus. It is chronic, progressive, and is usually
More informationGUIDELINES FOR HOSPITALS WITH NEONATAL INTENSIVE CARE SERVICE : REGULATION 4 OF THE PRIVATE HOSPITALS AND MEDICAL CLINICS REGULATIONS [CAP 248, Rg 1] I Introduction 1. These Guidelines serve as a guide
More informationACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) S. Agarwal, MD, S. Kache MD
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) S. Agarwal, MD, S. Kache MD Definition ARDS is a clinical syndrome of lung injury with hypoxic respiratory failure caused by intense pulmonary inflammation that
More informationPulmonary Diseases. Lung Disease: Pathophysiology, Medical and Exercise Programming. Overview of Pathophysiology
Lung Disease: Pathophysiology, Medical and Exercise Programming Overview of Pathophysiology Ventilatory Impairments Increased airway resistance Reduced compliance Increased work of breathing Ventilatory
More informationSAMPLE. UK Obstetric Surveillance System. Management of Pregnancy following Laparoscopic Adjustable Gastric Band Surgery.
ID Number: UK Obstetric Surveillance System Management of Pregnancy following Laparoscopic Adjustable Gastric Band Surgery Case Definition: Study 04/11 Data Collection Form - Please report any woman delivering
More informationA. All cells need oxygen and release carbon dioxide why?
I. Introduction: Describe how the cardiovascular and respiratory systems interact to supply O 2 and eliminate CO 2. A. All cells need oxygen and release carbon dioxide why? B. Two systems that help to
More informationDepartment of Surgery
What is emphysema? 2004 Regents of the University of Michigan Emphysema is a chronic disease of the lungs characterized by thinning and overexpansion of the lung-like blisters (bullae) in the lung tissue.
More informationAUSTRALIA AND NEW ZEALAND FACTSHEET
AUSTRALIA AND NEW ZEALAND FACTSHEET What is Stillbirth? In Australia and New Zealand, stillbirth is the death of a baby before or during birth, from the 20 th week of pregnancy onwards, or 400 grams birthweight.
More informationPreoperative Laboratory and Diagnostic Studies
Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no
More informationSWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies
SWISS SOCIETY OF NEONATOLOGY Umbilical cord complications in two subsequent pregnancies June 2006 2 Hetzel PG, Godi E, Bührer C, Department of Neonatology (HPG, BC), University Children s Hospital, Basel,
More informationABSTRACT LABOR AND DELIVERY
ABSTRACT POLICY Prior to fetal viability, intentionally undertaking delivery of a fetus is the equivalent of abortion and is not permissible. After fetal viability has been reached, intentionally undertaking
More informationPediatrix Medical Group BabySteps and the Clinical Data Warehouse
Pediatrix Medical Group BabySteps and the Clinical Data Warehouse Pediatrix Medical Group Reese H Clark MD Dan Ellsbury MD Alan Spitzer MD Duke Clinical Research Institute Brian Smith MD MPH MHS Danny
More informationDisclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease
March of Dimes New York State Chapter 36th Annual Perinatal Nurses Conference Promoting Perinatal Health Through Evidence Based Practice Not As Pink As You Think: Pulse Oximetry Screening For Critical
More informationPregnancy and Substance Abuse
Pregnancy and Substance Abuse Introduction When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your
More informationSWISS SOCIETY OF NEONATOLOGY. Selective bronchial occlusion in a preterm infant with unilateral pulmonary interstitial emphysema
SWISS SOCIETY OF NEONATOLOGY Selective bronchial occlusion in a preterm infant with unilateral pulmonary interstitial emphysema December 2002 2 Riedel T, Pfenninger J, Pediatric Intensive Care Unit, University
More informationRemove this cover sheet before redistributing and replace it with your own. Please ensure that DPHHS is included on your HAN distribution list.
State of Montana Health Alert Network DPHHS HAN ADVISORY Cover Sheet DATE: May 15, 2012 SUBJECT: Pertussis INSTRUCTIONS: DISTRIBUTE to your local HAN contacts. This HAN is intended for general sharing
More information4/15/2013. Maribeth Inturrisi RN MS CNS CDE Perinatal Diabetes Educator mbturris@comcast.net
Maribeth Inturrisi RN MS CNS CDE Perinatal Diabetes Educator mbturris@comcast.net List the potential complications associated with diabetes during labor. Identify the 2 most important interventions essential
More informationSafe Zone: CV PIP < 26; HFOV: MAP < 16; HFJV: MAP < 16 Dopamine infusion up to 20 mcg/kg/min Epinephrine infusion up to 0.1 mcg /kg/min.
Congenital Diaphragmatic Hernia: Management Guidelines 5-2006 Issued By: Division of Neonatology Reviewed: Effective Date: Categories: Chronicity Document Congenital Diaphragmatic Hernia: Management Guidelines
More informationPNEUMONIA Debra Mercer BSN, RN, RRT
PNEUMONIA Debra Mercer BSN, RN, RRT 1 Objectives Following this presentation the participant will demonstrate understanding of pneumonia by successful completion of the Pneumonia I.Q. Quiz (7 or more correct
More informationZika Virus. Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases
Zika Virus Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases What is the incubation period for Zika virus infection? Unknown but likely to be several
More informationChildhood Diseases and potential risks during pregnancy: (All information available on the March of Dimes Web Site.) http://www.modimes.
Childhood Diseases and potential risks during pregnancy: (All information available on the March of Dimes Web Site.) http://www.modimes.org/ Fifth disease (erythema infectiosum) is a common, mild, childhood
More informationCritical Congenital Heart Disease (CCHD) Screening
Critical Congenital Heart Disease (CCHD) Screening Screening The Florida Genetics and Newborn Screening Advisory Council recommended to the Department of Health that CCHD be added to the panel of disorders
More informationInnovative use of Neonatal Nurse Practitioners in Rural Hawaii
Innovative use of Neonatal Nurse Practitioners in Rural Hawaii Petri Pate Pieron, MSN, MPH, APRN Rx, CPNP, NNP Presentation was supported by NIH 1 R25 RR019321 Clinical Research Education and Career Development
More informationTransient Hypogammaglobulinemia of Infancy. Chapter 7
Transient Hypogammaglobulinemia of Infancy Chapter 7 An unborn baby makes no IgG (antibody) and only slowly starts producing it after birth. However, starting at about the sixth month of pregnancy, the
More informationICD-10 OVERVIEW Coding Guidelines For OB/GYN
ICD-10 OVERVIEW Coding Guidelines For OB/GYN ICD-10 Chapter 15 Pregnancy, Childbirth and the Puerperium (O00-O9A) Note: Codes from this chapter are for use only on maternal records, NEVER on newborn records.
More informationNRP Study Guide. This packet is intended for review only. Requirements to successfully complete NRP:
This packet is intended for review only Requirements to successfully complete NRP: Completed NRP Pretest is required for admission to the course. Score 84% on the multiplechoice posttest. You may be allowed
More informationSafety of Antidepressants in Pregnancy and Breastfeeding
Safety of Antidepressants in Pregnancy and Breastfeeding Exceptional healthcare, personally delivered Background Depression and anxiety disorders are common during pregnancy, affecting nearly one in every
More informationStratification of Risk of Early-Onset Sepsis in Newborns 34 Weeks Gestation
Stratification of Risk of Early-Onset Sepsis in Newborns 34 Weeks Gestation New England Association of Neonatologists 16 th Annual Braden E. Griffin, MD Memorial Symposium Karen M. Puopolo, MD, PhD Division
More informationCLINICAL QUALITY MEASURES FINALIZED FOR ELIGIBLE HOSPITALS AND CRITICAL ACCESS HOSPITALS BEGINNING WITH FY 2014
CLINICAL QUALITY MEASURES FINALIZED FOR ELIGIBLE HOSPITALS AND CRITICAL ACCESS HOSPITALS BEGINNING WITH FY 2014 e 55 0495 2 Emergency Department (ED)- 1 Emergency Department Throughput Median time from
More informationMECHANICAL VENTILATION IN THE NEONATE
Supplemental Resources for the PICU/NICU MECHANICAL VENTILATION IN THE NEONATE I. GENERAL PRINCIPLES A. NEONATAL VENTILATORS We use three types of neonatal ventilators in the NICU: 1. SIMV (Synchronized
More informationThe flu vaccination WINTER 2016/17. Who should have it and why. Flu mmunisation 2016/17
The flu vaccination WINTER 2016/17 Who should have it and why Flu mmunisation 2016/17 The flu vaccination 1 Winter 2016/17 Helping to protect everyone, every winter This leaflet explains how you can help
More informationMANA Home Birth Data 2004-2009: Consumer Considerations
MANA Home Birth Data 2004-2009: Consumer Considerations By: Lauren Korfine, PhD U.S. maternity care costs continue to rise without evidence of improving outcomes for women or babies. The cesarean section
More informationFacts about Congenital Heart Defects
Facts about Congenital Heart Defects Joseph A. Sweatlock, Ph.D., DABT New Jersey Department of Health Early Identification & Monitoring Program Congenital heart defects are conditions that are present
More informationCongenital heart defects
CONGENITAL ANOMALY REGISTER & INFORMATION SERVICE COFRESTR ANOMALEDDAU CYNHENID Congenital heart defects Cardiovascular defects are by far the commonest major group of congenital anomalies. Development
More informationHome Health Agencies. Ante & Postpartum Members
FIRST PRIORITY HEALTH /FIRST PRIORITY LIFE INSURANCE COMPANY BLUE CROSS OF NORTHEASTERN PENNSYLVANIA CREDENTIALING CRITERIA FOR OBSTETRIC NURSES IN HOME CARE ADMINISTRATIVE PRACTICE GUIDELINE PROVIDER
More informationCHLAMYDIA SCREENING IN WOMEN
CHLAMYDIA SCREENING IN WOMEN APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE What screening should be done? NCQA ACCEPTED CODES DOCUMENTATION
More informationNHS FORTH VALLEY Neonatal Oxygen Saturation Guideline
NHS FORTH VALLEY Neonatal Oxygen Saturation Guideline Date of First Issue 11/07/2011 Approved 30/09/2011 Current Issue Date 07/09/2011 Review Date July 2013 Version 1 EQIA Yes 22/10/2011 Author / Contact
More informationDoppler Ultrasound in the Management of Fetal Growth Restriction Chukwuma I. Onyeije, M.D. Atlanta Perinatal Associates
Doppler Ultrasound in the Management of Fetal Growth Restriction Chukwuma I. Onyeije, M.D. Atlanta Perinatal Associates 1 For your convenience a copy of this lecture is available for review and download
More informationNICU Reporting. Alyssa Yang CDC/CSTE Applied Epidemiology Fellow February 28, 2014
NICU Reporting Alyssa Yang CDC/CSTE Applied Epidemiology Fellow February 28, 2014 NICU Definitions Level I nurseries are normal newborn nurseries. For this discussion, NICU will refer to Level II and III
More information5/30/2014 OBJECTIVES THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM. Disclosure
THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM Ona Fofah, MD FAAP Assistant Professor of Pediatrics Director, Division of Neonatology Department of Pediatrics Rutgers- NJMS, Newark OBJECTIVES
More informationRSV infection. Information about RSV and how you can reduce the risk of your infant developing a severe infection.
RSV infection Information about RSV and how you can reduce the risk of your infant developing a severe infection. What is RSV? RSV is one of the most common respiratory viruses and is spread easily. By
More information2008 Coding Questions and Answers
2008 Coding Questions and Answers 1. An infant is born at 29 wks gestation and has RDS. His birthweight is 1200 gms. He is admitted to the NICU. It is evident that he has severe RDS and a decision is made
More informationNEONATAL RESUSCITATION PROVIDER (NRP) RECERTIFICATION TABLE OF CONTENTS
NEONATAL RESUSCITATION PROVIDER (NRP) RECERTIFICATION TABLE OF CONTENTS NEONATAL FLOW ALGORITHM.2 INTRODUCTION 3 ANTICIPATION OF RESUSCITATION 4 TEMPERATURE CONTROL.4 CLEARING THE AIRWAY OF MECONIUM 5
More informationNEONATAL CLINICAL PRACTICE GUIDELINE
NEONATAL CLINICAL PRACTICE GUIDELINE Title: Routine Screening of Neonates Approval Date: January 2015 Approved by: Neonatal Patient Care Teams, HSC & SBH Child Health Standards Committee Pages: 1 of 6
More informationAccuracy and reliability of pulse oximetry in
Accuracy and reliability of pulse oximetry in premature neonates with respiratory distress GINNY W. HENDERSON, CRNA, MS Concordville, Pennsylvania Continuous noninvasive monitoring of oxygenation in premature
More informationRESPIRATORY VENTILATION Page 1
Page 1 VENTILATION PARAMETERS A. Lung Volumes 1. Basic volumes: elements a. Tidal Volume (V T, TV): volume of gas exchanged each breath; can change as ventilation pattern changes b. Inspiratory Reserve
More informationMechanical Ventilation
Mechanical Ventilation 127 Mechanical Ventilation William Benitz, M.D. Caring for a mechanically ventilated neonate continues to unnecessarily strike fear in the heart of many a resident. This fear is
More informationDRG 475 Respiratory System Diagnosis with Ventilator Support. ICD-9-CM Coding Guidelines
DRG 475 Respiratory System Diagnosis with Ventilator Support ICD-9-CM Coding G The below listed g are not inclusive. The coder should refer to the applicable Coding Clinic g for additional information.
More informationGeneral and Objectives Clinical Skills for. Nursing Students in Maternity and Gynecology. Nursing Department
General and Objectives Clinical Skills for Nursing Students in Maternity and Gynecology Nursing Department Objectives and clinical skills of Antenatal unit Provide antenatal care to woman during normal
More informationNewborn outcomes after cesarean section for fetal distress in BC
Newborn outcomes after cesarean section for fetal distress in BC Patricia Janssen, PhD, UBC School of Population and Public Health Scientist, Child and Family Research Institute Kevin Jenniskens, MSc,
More informationBrenda Neff MSN, RN, NE BC
Brenda Neff MSN, RN, NE BC 1400 s newborns have a soul 1600 s estimated that only 10% of the abandoned infants reached the age of 5 years. 1857 first incubator documented in western lit 1857 first incubator
More informationWhat women can do to optimise their health during pregnancy and that of their baby Claire Roberts
Periconception Planning to Protect Pregnancy and Infant Health 2015 What women can do to optimise their health during pregnancy and that of their baby Claire Roberts Pregnancy Complications Preterm Birth
More informationRegions Hospital Delineation of Privileges Nurse Practitioner
Regions Hospital Delineation of Privileges Nurse Practitioner Applicant s Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic
More informationRespiratory Syncytial Virus (RSV)
Respiratory Syncytial Virus (RSV) What is? is a common virus that infects the linings of the airways - the nose, throat, windpipe, bronchi and bronchioles (the air passages of the lungs). RSV is found
More informationAntidepressants in Pregnancy D R S N E H A P A R G H I
Antidepressants in Pregnancy D R S N E H A P A R G H I Overview Depression and its effects Antidepressants and their effects Birth defects Miscarriage Neonatal withdrawal Longterm consequences Breastfeeding
More informationTACO vs. TRALI: Recognition, Differentiation, and Investigation of Pulmonary Transfusion Reactions
TACO vs. TRALI: Recognition, Differentiation, and Investigation of Pulmonary Transfusion Reactions Shealynn Harris, M.D. Assistant Medical Director American Red Cross Blood Services Southern Region Case
More informationPrenatal Factors Influencing the Interpretation of Cord Blood Thyroid Stimulating Hormone Levels
Original Article DOI: 1.17354/ijss/15/115 Prenatal Factors Influencing the Interpretation of Cord Blood Thyroid Stimulating Hormone Levels Divya Durga 1, Sudha Rudrappa 2, Rajendra Kumar 3, SN Manjunath
More informationCardiovascular Pathophysiology:
Cardiovascular Pathophysiology: Right to Left Shunts aka Cyanotic Lesions Ismee A. Williams, MD, MS iib6@columbia.edu Pediatric Cardiology What is Cyanosis? Bluish discoloration of skin that occurs when
More informationEmbryology. From Conception through Birth. From Conception through Death
Embryology From Conception through Birth From Conception through Death - Immune system 18 months after birth - Lungs 3-8 years after birth - Nervous 12 years after birth - Reproductive Puberty - Skeletal
More informationDocumenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC
Documenting & Coding Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Sr. Provider Training & Development Consultant Professional Profile David Brigner currently performs
More informationObjective of This Lecture
Component 2: The Culture of Health Care Unit 3: Health Care Settings The Places Where Care Is Delivered Lecture 5 This material was developed by Oregon Health & Science University, funded by the Department
More informationSWISS SOCIETY OF NEONATOLOGY. Congenital cutaneous candidiasis (CCC): a rare skin disorder of the neonate
SWISS SOCIETY OF NEONATOLOGY Congenital cutaneous candidiasis (CCC): a rare skin disorder of the neonate April 2003 2 Diana A, Martin G, Ecoffey M, and Pfister R, Department of Pediatrics and Department
More informationDr.U.Venkataramana Rao DNB Resident, Neonatology Unit, Southern Railway HQ Hospital.
NEONATAL DENGUE Dr.N.Kannan Prof and HOD, Dpt of Pediatrics & Child Health, Southern Railway HQ Hospital, Ayanavaram. Dr.U.Venkataramana Rao DNB Resident, Neonatology Unit, Southern Railway HQ Hospital.
More informationUniversity of Kansas. Respiratory Care Education
University of Kansas Respiratory Care Education What is Respiratory Care? Respiratory Care is the health profession that specializes in the promotion of optimum cardiopulmonary function and health Respiratory
More informationPregnancy and Tuberculosis. Patient and Public information sheet
Pregnancy and Tuberculosis Patient and Public information sheet Who is at risk of TB? Anyone can catch TB, but it is possible that pregnant women have a slightly higher risk of TB. Some people are more
More informationChickenpox in pregnancy: what you need to know
Chickenpox in pregnancy: what you need to know First published December 2003 Revised edition published November 2008 What is chickenpox? Chickenpox is a very infectious illness caused by a virus called
More informationCLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC)
CLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC) 1. Aim/Purpose of this Guideline 1.1. Due to a rise in the caesarean section rate there are increasing numbers of pregnant women who
More informationHydroxyurea Treatment for Sickle Cell Disease
Hydroxyurea Treatment for Sickle Cell Disease Before hydroxyurea After hydroxyurea Hydroxyurea Treatment for Sickle Cell Disease 1 This document is not intended to take the place of the care and attention
More informationPregnancy and Tuberculosis. Information for clinicians
Pregnancy and Tuberculosis Information for clinicians When to suspect Tuberculosis (TB)? Who is at risk of TB during pregnancy? Recent research suggests that new mothers are at an increased risk of TB
More informationLecture one lung pathology 4 th year MBBS. Dr Asgher Khan Demonstrator of pathology Rawalpindi Medical College Rwp.
Lecture one lung pathology 4 th year MBBS Dr Asgher Khan Demonstrator of pathology Rawalpindi Medical College Rwp. Expectation at end of lecture Brief review of anatomy and physiology related to lungs
More informationWendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health
Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health Describe local trends in birth Identify 3 perinatal health problems Identify 3 leading causes of infant death Age Class
More informationCongestive Heart Failure
William Herring, M.D. 2002 Congestive Heart Failure In Slide Show mode, to advance slides, press spacebar or click left mouse button Congestive Heart Failure Causes of Coronary artery disease Hypertension
More informationSTUDY GUIDE 1.1: NURSING DIAGNOSTIC STATEMENTS AND COMPREHENSIVE PLANS OF CARE
STUDY GUIDE 1.1: NURSING DIAGNOSTIC STATEMENTS AND COMPREHENSIVE PLANS OF CARE WHAT IS A NURSING DIAGNOSIS? A nursing diagnosis is a clinical judgment about individual, family, or community responses to
More informationDifferentiation between normal and abnormal fetal growth
Differentiation between normal and abnormal fetal growth JASON GARDOSI MD FRCSE FRCOG Director, West Midlands Perinatal Institute, St Chad s Court, 213 Hagley Road, Birmingham B16 9RG, U.K. Tel +44 (0)121
More informationX-Plain Sinus Surgery Reference Summary
X-Plain Sinus Surgery Reference Summary Introduction Sinus surgery is a very common and safe operation. Your doctor may recommend that you have sinus surgery. The decision whether or not to have sinus
More information