01.新生儿呼吸困难.ppt

新生儿呼吸困难 浙江大学医学院附属儿童医院 孙 眉 月 Pulmonary causes of tachypnea Mechanical (restrictive) Rib cage anomalies (asphyxiating thoracic dystrophy) Pneumothorax Pneumomediastinum Pleural effusion Chylothorax Severe abdominal distension Pulmonary causes of tachypnea Developmental abnormality TEF CCAM CDH Sequestration Pulmonary hypoplasia Lobar emphysema Lung cyst Pulmonary causes of tachypnea Airway anomalies Choanal stenosis, atresia Laryngeal web Laryngotracheomalacia Bronchomalcia Subglottic stenosis Pulmonary causes of tachypnea Parenchymal TTN,HMD Pulmonary edema Delayed maturation of epithelial sodium channel(ENaC) Aspiration syndromes-meconium, mucus, milk, blood Pneumonia Pneumatocele Pulmonary hemorrhage Interstitial pneumonitis PPHN Nonpulmonary causes of tachypnea Cardiac Left-to-right shunt – pulmonary blood flow Congestive cardiac failure PDA Truncus Coarctation/interrupted aortic arch Atrioventricular (AV) canal AV malformation with high output failure Nonpulmonary causes of tachypnea Neurologic Postasphyxial state Subarachnoid hemorrhage Infections—meningitis Metabolic Metabolic acidosis Hypoglycemia Hypocalcemia Sepsis Nonpulmonary causes of tachypnea Miscellaneous Hyperthermia Hypothermia Narcotic withdrawal Pain Hirschsprung’s Large for gestational age-infant of diabetic mother (LGA-IDM) Trisomy-21 Clinical history and diagnosis of causes for tachypnea History Likely diagnosis Maternal history Diabetes TTN, RDS,hypoglycemia, LGA, CHD Asthma TTN Drugs Narcotic withdrawal Pregnancy induced Intrauterine growth retardation (IUGR), hypertension (PIH) polycythemia, hypoglycemia Polyhydramnios