Neonatal respiratory distress syndrome, surfactant therapy, and pediatric airway management concepts tested on respiratory therapist certification exams.
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- What is Respiratory Distress Syndrome (RDS) in neonates primarily caused by?
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Deficiency of pulmonary surfactant, which impairs alveolar inflation and gas exchange- What are the four main components of surfactant?
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Lipids (90%) and proteins (10%); lipids include phospholipids and cholesterol; proteins include surfactant proteins A, B, C, and D- At what gestational age does fetal lung surfactant production typically begin?
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Around 24-26 weeks; mature levels are not reached until 35+ weeks- What is the primary indication for surfactant therapy in a newborn?
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Confirmed or suspected Respiratory Distress Syndrome (RDS) requiring mechanical ventilation or CPAP support- Name three exogenous surfactant products used clinically
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Exosurf (synthetic), Survanta (beractant, bovine), and Infasurf (calfactant, bovine)- What is the standard initial dose of surfactant administered to a neonate?
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100-200 mg/kg, given intratracheally in 2-4 divided doses- What major risk factors increase the likelihood of RDS in a newborn?
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Prematurity, male gender, maternal diabetes, cesarean delivery without labor, and perinatal asphyxia- What is the classic chest X-ray appearance of RDS?
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Bilateral ground-glass opacity with a reticulogranular pattern and air bronchograms; described as the 'white-out lung'- Which clinical signs are characteristic of RDS in a newborn?
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Grunting, flaring, retractions, tachypnea, and cyanosis appearing within the first few hours of life- What is the Apgar score used to assess?
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Newborn health at 1 and 5 minutes after birth, scoring appearance, pulse, grimace, activity, and respiration (0-10 total)- How do antenatal corticosteroids reduce the risk of RDS?
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They accelerate fetal lung maturity and increase surfactant production in the developing fetus- What is the recommended endotracheal tube size for a term newborn?
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3.5-4.0 mm internal diameter; size is approximately equal to the width of the infant's pinky fingernail- What is Transient Tachypnea of the Newborn (TTN)?
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A self-limited condition caused by retained fetal lung fluid, presenting with tachypnea, mild retractions, and grunting within the first few hours of life- What chest X-ray finding is typical of Transient Tachypnea of the Newborn?
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Bilateral hyperinflation, fluid in the interlobar fissures, and a classic 'wet lung' or 'wet baby' appearance- What is Meconium Aspiration Syndrome (MAS) and when does it occur?
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Aspiration of meconium-stained amniotic fluid in utero or during delivery, typically in term or post-term infants with fetal hypoxia
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