慢性肺疾病(II)--预防及治疗.pdf

Chronic lung disease (II) -- Neonatal prevention and managementprevention and management 慢性肺疾病(II)--預防及治療 陳秀玲 高醫小兒科部 新生兒科 E-mail: 840062@.tw TEL 07-3121101 ext 6529; PHS 0966200282 Neonatal pprevention PPullmonary surf facttantt: d decrease surf face t tensiion as alveolar surface decreases Young- Lapplace Law IInflflatiing pressure 2 ×surface tension = bubble radiusbubble radius From Perinatal and Pediatric Respiratory Care 2nd ed. P.235 Normal term baby • At birth ▫Clearance of alveolar fluid present during fetalClearance of alveolar fluid present during fetal life ▫▫Mature amounts of alveolar surfactantMature amounts of alveolar surfactant The opening pressures are relatively low Pulmonary compliance is normalPulmonary compliance is normal The work of breathing is minimal LLow surf face tensi ion i in al lveolili; k keeps l lungs edema-free Why does surfactant deficiency mater in the lung?lung? High surface tension in the lungHigh surface tension in the lung  air spaces tend to contract  lowering lung compliancelowering lung compliance  increasing the work of breathing  MMore respi irattory d driive f from th the b braiin i is required to maintain normal alveolar ventiltilatition an dd gas exchhange In prematur iity w iith RDSh RDS….. • Intercostal an