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    Hyaline Membrane Disease

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    E=MC2
    This document discusses hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS). It affects premature babies and those with certain risk factors. HMD is caused by a deficiency of surfactant in the lungs, which helps keep air spaces open. This leads to collapsed alveoli, impaired gas exchange, and respiratory failure. Symptoms include fast breathing, grunting, and cyanosis. Diagnosis involves history, symptoms, and chest x-ray. Treatment focuses on surfactant replacement, oxygen supplementation, CPAP, mechanical ventilation if needed, and supportive care. Outcomes depend on gestational age but intensive care can reduce mortality from HMD.

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    Download as PPT, PDF, TXT or read online from Scribd

    Hyaline Membrane Disease

    Uploaded by

    E=MC2
    67 views20 pages
    This document discusses hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS). It affects premature babies and those with certain risk factors. HMD is caused by a deficiency of surfactant in the lungs, which helps keep air spaces open. This leads to collapsed alveoli, impaired gas exchange, and respiratory failure. Symptoms include fast breathing, grunting, and cyanosis. Diagnosis involves history, symptoms, and chest x-ray. Treatment focuses on surfactant replacement, oxygen supplementation, CPAP, mechanical ventilation if needed, and supportive care. Outcomes depend on gestational age but intensive care can reduce mortality from HMD.

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    HMD

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    This document discusses hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS). It affects premature babies and those with certain risk factors. HMD is caused by a deficiency of surfactant in the lungs, which helps keep air spaces open. This leads to collapsed alveoli, impaired gas exchange, and respiratory failure. Symptoms include fast breathing, grunting, and cyanosis. Diagnosis involves history, symptoms, and chest x-ray. Treatment focuses on surfactant replacement, oxygen supplementation, CPAP, mechanical ventilation if needed, and supportive care. Outcomes depend on gestational age but intensive care can reduce mortality from HMD.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    67 views20 pages

    Hyaline Membrane Disease

    Uploaded by

    E=MC2
    This document discusses hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS). It affects premature babies and those with certain risk factors. HMD is caused by a deficiency of surfactant in the lungs, which helps keep air spaces open. This leads to collapsed alveoli, impaired gas exchange, and respiratory failure. Symptoms include fast breathing, grunting, and cyanosis. Diagnosis involves history, symptoms, and chest x-ray. Treatment focuses on surfactant replacement, oxygen supplementation, CPAP, mechanical ventilation if needed, and supportive care. Outcomes depend on gestational age but intensive care can reduce mortality from HMD.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    Hyaline Membrane Disease

    Pediatric Dept.
    Atma Jaya University

    Insidens

    Sering pada bayi prematur


    Bayi dengan ibu DM
    Kehamilan multipel (Kembar)
    Melahirkan dengan cara Sectio Caesarea
    Bayi laki laki

    Etiology
    Defisiensi surfaktan
    Surfaktan (Surface active Lipoprotein) *
    Dipalmitoylphosphatidylcholine ( lecithin )
    Phosphatidylglyserol
    Phosphatidyletanolamine
    Phosphatidylinositrol
    Apoproteins ( SP A, B, C, D )
    Cholesterol

    Pathophysiology
    Diminished surfactant
    Impaired cellular
    metabolism
    Alveolar
    hypoperfusion

    Progressive atelectasis
    Hypoventilation
    (V/Q mismatched)
    pH , pO2 , pCO2

    Pulmonary
    vasoconstriction

    Hypotension

    Clinical manifestation

    Tachypnea
    Prominent grunting (nafas seperti mengedan)
    Intercostal and subcostal retractions
    Nasal flaring (pernafasan cuping hidung)
    Cyanosis

    Diagnosis
    History
    Clinical manifestation
    Chest roentgenogram *

    Differential diagnosis

    Sepsis
    Cyanotic heart disease
    Persistent pulmonary hipertension
    Aspiration syndrome
    Spontaneous pneumothorax

    Prevention
    Dexamethasone or betamethasone to
    women 48 hr before delivery of fetus
    between 24 and 34 weeks of gestation.
    Artificial surfactant into the trachea of
    symptomatic premature infants immediately
    after birth or during the first 24 hr of life
    reduces the mortality from HMD

    Treatment
    A.
    B.
    C.
    D.
    E.

    Surfactant replacement therapy *


    Oxygen *
    CPAP *
    Mechanical ventilation *
    Supportive therapy *

    Complication

    Tracheal intubation
    Umbilical catheterization
    PDA ( Patent Ductus Arteriosus )
    CLD ( Chronic Lung Disease )

    Prognosis
    Early provision of intensive observation
    and care of high risk newborn infants can
    reduce the mortality due to HMD
    Mortality increases with decreasing
    gestational age

    THANK YOU

    Surfactant *
    Reduce the surface tension
    Maintain alveolar stability by preventing
    the collapse of small air space at end
    expiration

    Chest roentgenogram *
    Reticular granular pattern
    Air bronchogram

    Surfactant replacement therapy


    Survanta ( Bovine surfactant extract )
    Exosurf Neonatal ( Syntetics surfactant
    consisting of Dipalmitoyl phosphatidylcholine,
    emulsifying, & dispersing agents )

    Surfactant replacement therapy *


    Prophylactic vs Early rescue treatment
    No significant difference if Rescue Treatment is
    given within 2 hours after birth ( Window of
    treatment )

    Single Vs Multiple doses


    No clinically advantages in administering more
    than 2 doses of surfactant
    Recommended : 2 dose of surfactant
    2 dose of Exosurf or 4 dose of Survanta

    Oxygen *
    Oxygen is given to maintain pO2 between
    50 and 80 mmHg ( > 90 % saturation )
    O2 is warmed, humidified, and delivered
    through an air-oxygen blender that allows
    precise control over the O2 Concentration

    CPAP *
    Indications
    - Infants with RDS who have mild respiratory
    distress
    - Require an FiO2 < 0,4 to maintain a PaO2
    of 50 to 80 mm Hg
    - PaCO2 < 50 mm Hg

    Mechanical ventilation *
    Indications
    - PaCO2 > 50 mm Hg or rapidly increasing
    - PaO2 < 50 mm Hg or O2 saturation < 90 %
    with FiO2 > 0.50
    - Severe apnea

    Supportive therapy *
    Temperature
    Fluids and nutrition
    Circulation
    HR, BP, Peripheral perfusion

    Possible infection
    Blood cultures and complete blood count

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