Caso clinico sobre bebe prematuro com cianose e stress respiratorio.

1. CLINICAL
CASE
Lana Mota Chagas

2. CLINIC
 Female premature newborn (27 weeks) presents:
 Difficulty in breathing;
 Cyanosis;
 Cough;
 Tachypnea
 Expiratory grunting
 Nasal flaring
 Diabetic mother.

3. STUDIES, EXAMINATION AND
EVALUATION:
 O/E:
 Temp. 37.5°C
 BP: 86/58 mmHg
 RF: 60/min (Normal: 30-50/min)
 P: 148/min
 Oxygen levels: around 70%
 Chest X-ray
 CT scan

4. X-RAY EXAMS
PATIENT’S X-RAY NORMAL X-RAY

5. CT SCANS
PATIENT’S CT NORMAL CT

6. FINDINGS:
 Diffuse granular opacities
 Low lung volumes

7. DIAGNOSIS:
 SURFACTANT DEFICIENCY DISORDER
 It’sa respiratory disease, common in premature
newborns
 The primary cause is the inadequacy of the
surfactant fluid, which coats the internal walls of
the lungs.
 Ideally, the fetus’s lungs start making the surfactant
between the 26th and the 34th week; a reason why the
disorder is more common in premature infants.
 The syndrome is more frequent in infants of diabetic
mothers.

8. A BIT OF EMBRYOLOGY…
 While the embryo is inside the uterus, the lungs
are filled with amniotic fluid. When the newborn
cries for the first time and the breathing begins,
most of the fluid is reabsorbed. Once it happens,
the surfactant liquid remains deposited as a thin
layer on the alveolar cell membranes.
 When the air gets in, with the first breath, the
layer of surfactant protects the alveoli of a
possible collapse.
 When the baby cries, if there is no surfactant
liquid, or if it’s insufficient, the alveoli may
collapse.

9. TREATMENT:
 Surfactant Replacement Therapy: To provide
surfactant to the infants till they are capable of
producing their own surfactant. In such
situations surfactant is directly pushed into the
baby’s lungs using a breathing tube.
 Breathing Support and Oxygen Therapy: Often
in infants with surfactant deficiency, oxygen
therapy is recommended with the intention of
ensuring adequate oxygenation of the various
parts of the body and to assure that the
essentials organs of the body function
appropriately.

10. PROGNOSIS:
 The prognosis of this lung disease is variable,
depending on the severity of the disease.
 But in the case of this patient, the prognosis is
good and the child can have a normal life.

11. ANY QUESTIONS?

12. THANK YOU!!!