Surfactant Replacement in Neonates with Respiratory Distress Syndrome Type
The innovation of surfactant replacement therapy in the treatment of respiratory distress syndrome has proven to increase the survival and minimize the complications of the premature neonate. Replacing surfactant has lessened time on ventilators, and allowing the neonate and parents an opportunity to grow together earlier outside of intensive care. This paper will discuss the etiology of respiratory distress syndrome type I, the treatment options and nursing care of the neonate during surfactant replacement.
Respiratory distress syndrome type I is a decrease production of surfactant, a noncelluar chemical produced in the type II alveolar in the lungs that's primary function is to decrease the surface tensions and attraction between the type I alveolar walls. Respiration requires the alveolar walls to inflate and deflate continuously, while ventilating the alveoli are exposed to moisture causing an attraction between the alveolar walls. (Kenner, Lott, & Flandermeyer, 271) Surfactant primary function is to neutralize the attraction to prevent alveolar collapse during deflation.
The fetus begins to develop the type II alveoli at 22nd to 24th week of gestation, however these immature alveoli are incapable of supplying enough surfactant to meet the infant's respiratory needs. The fetus surfactant production begins to become adequate at the middle terminal stage of alveoli development and production becomes optimal at the 34th-to-36th week. (Porth, 1306) There are four types of surfactant produced by the type 2 alveoli known as primary surfactant proteins SP-A, SP-B, SP-C, and SP-D. SP-A and SP-D roles are inhibiting production of surfactant i...
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Acute respiratory distress syndrome (ARDS) is a condition where there is a low oxygen level in the blood this mostly affects the lungs, people who have sepsis will be affected by ARDS as there breathing rate will decrease. Another reason for a multi-organ dysfunctions is that there is a lack of blood being given to the organs this causes low blood pressure or as it’s called hypotension this mostly affects diabetic people which leads them to having sepsis. Also hypoxia which is a lack of oxygen is another pathological physiological outcome of sepsis as less oxygen is reaching the tissue this is due to the fact that there is less oxygen in the blood. This causes confusion and change in heart and breathing rate which can lead to
... immune system. The body’s immune system is beneficial to rid of illness and foreign invader our body note to be a threat such as parasite, virus, or bacteria but sometimes it can also reacts to a harmless substance. As a result to protect out immune system, the body manufacture a protective protein barrier called antibodies. This protective agent exhibit swelling and inflammation of tissues whenever an allergic reaction occurs as a response to eliminate the threat (Burks, Harthoorn,Van Ampting, Oude Nijhuis, Langford, Wopereis, & Harvey, 2015). In addition, the anatomical systems of babies are still developing in the sense that, they have small, sensitive airways in their lungs. In a situation of allergy contact, the airways become swollen as a result to rid virus and bacteria; and in response, babies start to cough, sneeze and can progress to wheezing and asthma.
Mphahlele, R. R. (2007). Caring for premature babies - a clinical guide for nurses. Professional Nursing Today, 11(1), 40-46.
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
Many questions about the causes of Sudden Infant Death Syndrome (SIDS), also known as “crib death,” are still unresolved. The mysterious and elusive nature of SIDS creates problems, doubts, and more questions. This paper will present some of the most commonly asked questions as well as the answers that have been uncovered by scientists after years of research and study.
Gardenhire, D. Rau's respiratory care pharmacology . (8th ed., p. 172). St. Louis, Missouri: Elsevier Mosby.
Although there are many factors that affect the development of the fetus, research on the specific effects of prenatal maternal stress and the resulting negative outcomes for the development of the fetus will be reviewed. While there is knowledge of these harmful effects in scientific and medical communities, researchers are still in the midst of discovering the results of these negative effects on human development. An overall review of the literature suggests that this topic is still relatively new in research as most of the articles make note that despite the amount of current research studies, there are still many unanswered questions.
There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.
...e baby still seems to have too much fluid in his or hers mouth or nose, the nurse may do further suctioning at this time. At one and five minutes after birth, an Apgar assessment will be done to evaluate the baby's heart rate, breathing, muscle tone, reflex response, and color. If the baby is doing well, the mother and the baby will not be separated. The nurse will come in from time to time to change diapers, check the babies temperature, and perform other tasks while the baby spends time with his or her mother and father (B. C. Board).
This paper will then explain the types of physical symptoms associated with NAS in the full-term and premature infant. It discusses the different classes of drugs and the unique symptoms newborns experience with each. Furthermore, it discusses the long-term cognitive and behavioral effects that newborns can experience as they grow. In addition, this paper discusses how Neonatal Abstinence Syndrome is diagnosed and the how the Finnegan neonatal scoring system is used to help physicians determine the severity of NAS in each newborn. Lastly, this paper explains the treatment for NAS and the important role of the nurse when caring for a newborn with Neonatal Abstinence Syndrome.
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that mostly affects premature infants. Premature infants have very few tiny alveoli that are not fully developed for the lungs to function normally. As a result, premature infants need respiratory support to provide oxygen or they need to be under mechanical ventilation in order to support their breathing. However, BPD is a result of the damage to the lungs caused by mechanical ventilation or by the long-term use of supplemental oxygen. This causes dysplasia and scarring of the air sacs and the damage will continue to affect alveoli that develop after birth. It will also affect the blood vessels which make it difficult for blood to go through the lungs, resulting in pulmonary hypertension and even heart failure. Most babies who have BPD are born with respiratory distress syndrome, a breathing disorder wherein fluid builds up in the alveoli which decreases the amount of oxygen reaching the bloodstream resulting in oxygen deprivation. The lungs are not completely formed or are unable to produce adequate surfactant, the liquid that covers the lungs in order to keep them open and aid in breathing once the infant is born. Without adequate surfactant, the lungs can collapse which causes difficulty in breathing. Because of this, the infant is not able to breathe and circulate sufficient levels of oxygen in order to support the other organs of the body. Most common symptoms of BPD are rapid and labored breathing,
Sudden infant death syndrome ( SIDS) is the greatest cause of infant deaths ranging from ages one month to one year. Most of these deaths occur before the age of six months. Normally, any unexplainable infant death is considered to be due to SIDS. Numerous attempts have been made to discover the exact cause of this syndrome. However,the only known pathology is that SIDS is due to a dysfunction or abnormality in the cardiac and/or respiratory systems. To this point, an exact and definite cause has not been named. This paper will attempt to present several of the proposed and hypothesized causes of SIDS.
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
Since premature babies don't secrete enough surfactant, a substance that is necessary for the alveoli to overcome surface tension, this causes the alveoli to collapse at each breath making it difficult for gas exchange to happen (Trevino). When it collapses, surface area is lower making it more difficult to breathe. The baby then ends up “breathing harder and harder trying to make up for the collapsed airways” (Thoracic Society).
Reddy, U. M., Zhang, J., Sun, L., Chen, Z., Raju, T. N., & Laughon, K. (2012). Neonatal mortality by attempted route of delivery in early preterm birth. American Journal of Obstetrics & Gynecology, 207(2). doi:10.1016/j.ajog.2012.06.023