NRDS case report（0411-2000）课件.ppt

Surfactant preparations licensed in Europe in 2013 Surfactant dose Last month… After have read European Consensus Guidelines on the Management of NRDS in Preterm Infants Li Wen-zao Department of Pediatrics? XinQiao Hospital A Case Report Medical history Male, 15 minutes after birth, Caesarean?birth 2. gestational age: 32+1 weeks birth weight : 1.65kg (G1P1) 3. Clear Amniotic fluid? 4. Apgar Score: 1’ 7, 5’ 9, 10’ 9 Personal history Gestational diabetes mellitus GDM Severe?preeclampsia Premature rupture of membrane 50 hours prenatal corticosteroids unfinished the course Mother: ?physical examination T 36.1℃, R 75/min , P160/min SO2?90%(nasal catheter O2 inhalation) Premature?appearance Moan cyanosis flaring of alaenasi coarse rales ? blood gas analysis pH 7.271 pCO2 57.8 mmHg pO2 65.9 mmHg sO2 75.3% cHCO3- 20.9 mmol/L ABE -4.2 mmol/L Acidosis Hypoxemia X-Ray (40min later) air bronchogram “grand glass” primary diagnosis 1. premature infant 2. low birth weight 3. NRDS? Ref：David G. S, Virgilio C，Gorm G, European Consensus Guidelines on the Management of NeonatalRespiratory Distress Syndrome in Preterm Infants – 2013 Update Neonatology 2013;103:353–368 DOI: 10.1159/000349928 NRDS diagnose (1) PaO250 mm Hg (6.6 kPa) in room air (2) Central cyanosis in room air or need for supplemental oxygen to maintain PaO250mmHg (6.6 kPa) (3) The classical chest X-ray appearances. Ref：David G. S, Virgilio C，Gorm G, European Consensus Guidelines on the Management of NeonatalRespiratory Distress Syndrome in Preterm Infants – 2013 Update Neonatology 2013;103:353–368 DOI: 10.1159/000349928 The Vermont Oxford Neonatal Network : Diagnose of the baby History Physical examination Auxiliary examination NRDS 1. First choice of therapy PS? MV? “Neonatal?even very?short?oxygen exposure,?will also increase the?oxidative stress....