Broncho pulmonary Dysplasia Foreign Body Aspiration ApneaALTE Lower Respiratory

Broncho pulmonary dysplasia foreign body aspiration

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Broncho-pulmonary Dysplasia Foreign Body Aspiration Apnea/ALTE Lower Respiratory Considerations o Alveoli maturity 32-36 weeks gestation o Respiratory smooth muscle more mature after 5 months old Bronchiolitis o Inflammation, mucus filling of smallest airways o Caused by bacteria or virus, most often by respiratory syncytial virus (RSV ) o Highly contagious o Increases mucus production o Cough o Fever o Irritability, loss of appetite o Wheezing, coarse lung sounds Bronchiolitis: Respiratory Syncytial Virus o Season is October-March o Generally, the younger the child, the more severe the case o Severity can range from mild cold-like symptoms to respiratory failure o Symptoms can last up to a month
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o Virus can live on surfaces for over 6 hours o Isolation: Contact/Droplet o ***BREAST MILK = HUGE protection against RSV and other dx Use saline when suctioning babies with wall suction so not to dry out membranes o RSV is particularly dangerous for: Age < 24 months History of chronic lung disease Congenital heart disease Premature birth Synagis is an RSV vaccine for those at high risk *not really a vaccine – has antibodies to protect against RSV Given monthly – costs 1500-2000/month – way cheaper than being admitted to ICU o Bronchiolitis: Diagnosis Nasopharyngeal culture Chest x-ray Hyperinflation Atelectasis o Bronchiolitis/RSV Treatment antibiotics, if indicated (usually viral) Frequent saline, suction only when needed. Causes irritation and swelling Suction before they eat (nose breathers) If retractions or having problems Oxygen, if indicated IVFs/tube feeding, if indicated Respiratory support – ventilator if needed Antipyretics Bronchodilators – albuterol not helpful against RSV, will give anyway Decongestants? Cough syrups? DO NOT GIVE ANYTHING until 6yrs old Give Tylenol, motrin, humidifiers, Over 12 months of age – can give honey (under = possible botulism) Prevention Pneumonia o Inflammation or infection of the bronchioles and alveolar spaces of the lungs o Can be viral or bacterial or due to aspiration o Cause fever, cough, abdominal and chest pain, coarse lung sounds o Pneumonia: Diagnosis Based on history and physical CXR may show areas of consolidation o Pneumonia: Treatment Oxygen Humidification Hydration Antibiotics Antipyretics Prevention Bronchodilators – albuterol Pulmonary Toileting – Incentive spirometer, blowing bubbles Pertussis o “whooping chough” o Caused by bacteria bordetella pertussis o Resistant strains are developing and many children are going unvaccinated o Leads to severe coughing spells , respiratory distress, and apnea o Starts with 1-2 weeks of mild cold symptoms followed by up to 4 weeks of severe coughing o Can lead to pneumonias o Up to 2 months old – most at risk
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o ***Mucus MUCH thicker than RSV, upper airway narrowing
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