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Respiratory Distress Syndrome of Prematurity
Infant Acute Respiratory Distress Syndrome

Presentation

Gastric and colonic polyposis are both present in 100% of patients with this diagnosis. Small bowel involvement is seen in 50% of patients. [radiopaedia.org]

This patient did not present with the cardinal manifestations of CCS which resulted in a delayed diagnosis. [spandidos-publications.com]

Neonatal respiratory distress syndrome Prevalence: 1-5 / 10 000 Inheritance: Not applicable Age of onset: Infancy, Neonatal ICD-10: P22.0 OMIM: 267450 UMLS: C0020192 C0035220 C0852283 MeSH: - GARD: - MedDRA: - The documents contained in this web site are presented [orpha.net]

Entire Body System

  • Inflammation

    Secretory phospholipase A2 plays an important role in inflammation and possible dysfunction of surfactants in ARDS. [ncbi.nlm.nih.gov]

    This is usually triggered by an event that leads to major systemic inflammation, which can be indirectly damage the capillary membrane or directly damage the capillary membrane. [youtube.com]

    ARDS is a lung condition where the patient suffers from sudden breathlessness, low blood oxygen levels and lung inflammation that could progress to respiratory failure. [medindia.net]

    […] of the pancreas can spread throughout the body Lung inflammation may occur following an infection that has spread through the blood to affect the whole body. [hse.ie]

    Inflammation of the lung parenchyma leads to impaired gas exchange with systemic release of inflammatory mediators, causing inflammation, hypoxemia and frequently multiple organ failure. This condition has a 90% death rate in untreated patients. [symcat.com]

  • Weakness

    It must be noted that the weak or ill-formed ribs of the preterm baby aggravate the situation causing deep retractions, insufficient inhalation and sometimes eventual collapse of the lungs where a ventilator is required to do the breathing for the baby [empowher.com]

    Muscle weakness Muscle weakness affects most people recovering from an episode of ARDS. This is because spending several weeks in bed and on a ventilator can result in a rapid weakening of the muscles. [hse.ie]

    Signs and symptoms and their causes[2][3] Weak cry sign of fatigue and shows the child is prioritising energy expenditure for work of breathing. [physio-pedia.com]

    Complications - Patients may suffer from complications like trauma during ventilation, infections, muscle weakness, kidney failure, stomach ulcers, anemia and even death. [medindia.net]

    Trouble doing day-to-day activities because of weakness and fatigue. Depression. Problems focusing on tasks and trouble with memory. ARDS is a serious condition, and getting better is hard work. Your life may be changed in important ways. [mottchildren.org]

  • Fatigue

    Symptoms of pediatric acute respiratory distress syndrome (ARDS) include: Abdominal pain (in pancreatitis) Cough (often with white or pink frothy sputum) Fatigue Fever Shortness of breath What are the causes of Pediatric Acute Respiratory Distress Syndrome [childrens.com]

    माप से मेरा अभिप्राय यह है कि लघु की एक मात्रा और गुरु की दो मात्राएं मानी जाती हैं. en The existence of these genetic syndromes brings forth. the fact that aging is a genetic phenomenon. hi अक्षर % # फ़ाइल % # में बहुत बड़ा है en My wife has chronic fatigue [hi.glosbe.com]

    Signs and symptoms and their causes[2][3] Weak cry sign of fatigue and shows the child is prioritising energy expenditure for work of breathing. [physio-pedia.com]

    Trouble doing day-to-day activities because of weakness and fatigue. Depression. Problems focusing on tasks and trouble with memory. ARDS is a serious condition, and getting better is hard work. Your life may be changed in important ways. [mottchildren.org]

  • Congestive Heart Failure

    failure Chest x-ray Analysis of coughed-up matter Occasionally, an echocardiogram (heart ultrasound), to rule out congestive heart failure Pulmonary artery catheterization taid in diagnostic work-up Bronchoscopy to analyze airways. [nurseslabs.com]

    heart failure on echocardiograph Right heart catheterization is now not recommended due to negative influence to prognosis Cryptogenic organizing pneumonia Migration of cardiac shadow Good response to corticosteroids Drug induced lung injury History [pathologyoutlines.com]

    Causes of death are attributable to severe cachexia, anemia, congestive heart failure, embolism, shock, bronchopneumonia, and postoperative complications. One third of patients die from intractable nutritional deficiency. [emedicine.medscape.com]

    Differential diagnosis Viral or Bacterial Pneumonia Pulmonary contusion Congestive Heart Failure Diffuse Alveolar Hemorrhage Acute Interstitial Pneumonia Idiopathic Acute Eosinophilic Pneumonia Leukemic Infiltrates Miliary tuberculosis Aspiration pneumonia [cancertherapyadvisor.com]

Respiratoric

  • Respiratory Distress

    Respiratory Distress Syndrome, Infant Synonyms of Respiratory Distress Syndrome, Infant Hyaline Membrane Disease Infantile Respiratory Distress Syndrome IRDS Subdivisions of Respiratory Distress Syndrome, Infant surfactant protein-B deficiency General [rarediseases.org]

    CONCLUSIONS: Exogenous pulmonary surfactant is an efficient medication for infants suffering acute respiratory distress syndrome after cardiac surgery. [ncbi.nlm.nih.gov]

    Infant respiratory distress syndrome is also known as neonatal respiratory distress syndrome or hyaline membrane disease. It is caused by developmental insufficiency of surfactant production and structural immaturity in the lungs of the infants. [imedpub.com]

    Homepage Rare diseases Search Search for a rare disease Infant acute respiratory distress syndrome Disease definition Infant acute respiratory distress syndrome is a lung disorder that affects premature infants caused by developmental insufficiency of [orpha.net]

    […] and respiratory distress syndrome in premature twins. 56 Marttila R...Hallman M 12483294 2003 4 Surfactant proteins A and B as interactive genetic determinants of neonatal respiratory distress syndrome. 56 Haataja R...Hallman M 11063734 2000 5 Association [malacards.org]

  • Pneumonia

    Surfactant inactivation--and dysfunction--is also a hallmark in newborns with meconium aspiration syndrome (MAS), pneumonia and other disorders affecting the pulmonary function. [ncbi.nlm.nih.gov]

    Predisposing Cause The largest subgroup was comprised of 13 children with pneumonia (including 1 child with aspiration). Three of the above had staphylococcal pneumonia. [indianpediatrics.net]

    Bacterial pneumonia Diffuse collagenous fibrosis Hyaline membranes Onset of respiratory failure 1 week after cardiac surgery Organizing pneumonia Board review answer #1 C. Hyaline membranes Back to top [pathologyoutlines.com]

    See Also 8 Pneumonia Nursing Care Plans 5 Pneumonia Nursing Care Plans Last Updated On: February 26, 2019 [nurseslabs.com]

  • Tachypnea

    The symptoms usually appear shortly after birth and may include tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, nasal flaring and cyanosis during breathing efforts. [orpha.net]

    Hypoxemia further increases tachypnea. (16)(18) Therefore, affected newborns present with marked tachypnea. Because tachypnea is a nonspecific symptom, additional clinical findings aid in narrowing the cause to a respiratory disorder. [ncbi.nlm.nih.gov]

    Direct Links to chapters: 1:59-Chapter 2: Transient Tachypnea of the Newborn 3:32-Chapter 3: Neonatal Pneumonia 5:11-Chapter 4: Respiratory Distress Syndrome 6:41-Chapter 5: Meconium Aspiration Syndrome 8:19-Chapter 6: Case Study Please visit: www.openpediatrics.org [youtube.com]

  • Dyspnea

    Definition (NCI_FDA) A condition of the newborn marked by dyspnea with cyanosis, most frequently occurring in premature infants, children of diabetic mothers and infants delivered by cesarean section, and sometimes with no predisposing cause. [fpnotebook.com]

    Patients initially present with acute onset cyanosis, dyspnea, and tachypnea. [amboss.com]

    Presentation Symptoms dyspnea, tachypnea during first hours of life nasal flaring expiratory grunting, intercostal, subxiphoid retractions Physical exam severe hypoxemia not responsive to 100% O 2 atelectasis results in intrapulmonary (right-to-left) [medbullets.com]

    Other names: Acute Respiratory Distress Syndrome; ARDS Medication List About Respiratory Distress Syndrome: A condition of the newborn marked by dyspnea with cyanosis, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, [drugs.com]

    […] on exertion followed by dyspnea at rest Hypoxia; PaO 2 /FIO 2 ≤ 300 mm Hg Often sepsis and MODS ( JAMA 2016;315:788 ) Respiratory dysfunction and physical disability may persist for months after remission of ARDS, with gradual improvement ( N Engl J [pathologyoutlines.com]

  • Respiratory Insufficiency

    In addition to causing respiratory insufficiency, RDS increases risk of intraventricular hemorrhage, tension pneumothorax, bronchopulmonary dysplasia, sepsis, and death. [msdmanuals.com]

    A syndrome characterized by progressive life-threatening respiratory insufficiency in the absence of known lung diseases, usually following a systemic insult such as surgery or major trauma. [icd10data.com]

    Ventilation of the acute respiratory distress syndrome: Looking for Mr. Goodmode. Anesthesiology 1994; 80:972-975. 6. Kirby RR, Downs JB, Civetta JM, et al. High level positive end expiratory pressure (PEEP) in acute respiratory insufficiency. [med.umich.edu]

Gastrointestinal

  • Vomiting

    Direct Breathing harmful fumes or smoke Chest trauma Inhaling vomit (aspiration) Near drowning Pneumonia Indirect Blood transfusions Injury that causes low blood pressure Pancreatitis (inflammation of the pancreas) Severe and widespread bacterial infection [childrens.com]

    The condition may be caused by severe trauma or injury to the lungs; conditions such as pneumonia, septic shock, aspiration (when vomit is breathed into the lungs); or complications from a lung transplant. [uabmedicine.org]

    Also known as Adult Respiratory Distress Syndrome, Respiratory Distress Syndrome, Causes Direct injury to the lungs: Chest trauma, such as a heavy blow Breathing vomit Breathing smoke, chemicals, or salt water Burns Indirect injury to the lungs: Severe [nurseslabs.com]

  • Abdominal Pain

    Symptoms of pediatric acute respiratory distress syndrome (ARDS) include: Abdominal pain (in pancreatitis) Cough (often with white or pink frothy sputum) Fatigue Fever Shortness of breath What are the causes of Pediatric Acute Respiratory Distress Syndrome [childrens.com]

    Consistent with this, in the present case study, the patient initially experienced diarrhea and hematochezia, followed by abdominal pain, nail and toenail loss, onychatrophy and hyperpigmentation. [spandidos-publications.com]

    Presenting symptoms include watery diarrhea with stool volumes of 4-6 L (steatorrhea and melena may also occur), dysgeusia, dry mouth, partial or total lack of appetite, weight loss (often >10 kg), constant or episodic abdominal pain, and weakness. [orpha.net]

    Systemic Implications and Complications The usual clinical presentation consists of diarrhea with abdominal pain, protein-losing enteropathy and associated weight loss, weakness, paresthesias and xerostomia. [dermatologyadvisor.com]

  • Nausea

    […] and cutaneous hyperpigmentation Pathophysiology No known genetic link; considered nonhereditary May represent an autoimmune disorder ( Digestion 2007;75:96 ) Clinical features Patients present with variable symptoms, including diarrhea, weight loss, nausea [pathologyoutlines.com]

    However, women are more likely than men to have: shortness of breath jaw pain upper back pain lightheadedness nausea vomiting In fact, some women who have had a heart attack report that their symptoms felt like the symptoms of the flu. [healthline.com]

    Gastrointestinal problems in Cronkhite–Canada syndrome include: Nausea and vomiting, loss of appetite, and weight loss, often with cachexia (physical wasting and malnutrition) Upper abdominal pain, watery diarrhoea, and melaena (bleeding) Swelling and [dermnetnz.org]

    These people may also have abnormally low levels of protein in the blood (protein-losing enteropathy), causing a feeling of general ill health (cachexia), malnutrition, nausea and vomiting. [rarediseases.org]

    Other prominent symptoms include weight loss, protein-losing enteropathy, diarrhea, abdominal pain, nausea and vomiting, dysgeusia, and atrophic tongue [2]. [karger.com]

Cardiovascular

  • Heart Failure

    failure Chest x-ray Analysis of coughed-up matter Occasionally, an echocardiogram (heart ultrasound), to rule out congestive heart failure Pulmonary artery catheterization taid in diagnostic work-up Bronchoscopy to analyze airways. [nurseslabs.com]

    Heart tests that look for signs of heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. This condition can cause fluid to build up in your lungs. [medicinenet.com]

    failure, fluid overload, or chronic lung disease are responsible for the infiltrates; or pulmonary artery occlusion pressure of 18 mm Hg • Oxygenation —PaO … View Full Text Log in Log in using your username and password Log in through your institution [bmj.com]

    Heart tests. These can rule out conditions such as heart failure (when your heart doesn’t pump blood through your body the way it should). [webmd.com]

    […] not explained by heart failure or volume overload decreased arterial PaO 2 /FiO 2 ratio mild ARDS: 201-300 mmHg (≤39.9 kPa) moderate ARDS: 101-200 mmHg (≤26.6 kPa) severe ARDS: ≤100 mmHg (≤13.3 kPa) It is of note that the clinical diagnosis of ARDS using [radiopaedia.org]

Musculoskeletal

  • Contusion

    Pulmonary causes fat embolism near-drowning viral pneumonia oxygen toxicity smoke inhalation disseminated intravascular coagulopathy aspiration of gastric contents lung contusion pancreatitis burns trauma septicemia hypovolemic shock head injury transfusion [radiopaedia.org]

    Acute Pancreatitis Hematopoietic stem cell transplantation Medication (e.g., salicylic acid, tricyclic antidepressants, bleomycin ) Recreational drug overdose (e.g., cocaine ) Primary damage to the lungs Pneumonia Aspiration Inhaled toxins Pulmonary contusion [amboss.com]

    […] categorized as being mild, moderate, or severe: ARDS Severity PaO2/FiO2* Mortality** Mild 200 – 300 27% Moderate 100 – 200 32% Severe < 100 45% *on PEEP 5+; **observed in cohort RISK FACTORS Direct pneumonia (46%) aspiration of gastric contents (29%) lung contusion [lifeinthefastlane.com]

    […] extrapulmonary origin Direct lung injury Indirect lung injury Common causes Infectious pneumonia Aspiration of gastric contents Common causes Sepsis Severe trauma or burn, especially with shock and multiple transfusions Less common causes Pulmonary contusion [pathologyoutlines.com]

    When To Suspect ARDS Causing Direct Injury • Pneumonia • Gastric aspiration • Less Common • Pulmonary contusion • Fat emboli • Near drowning • Inhalational injury Causing Indirect Injury • Sepsis • Shock after severe trauma • Less Common • Cardiopulmonary [slideshare.net]

Fetus

  • Hydrops Fetalis

    fetalis, inborn error of metabolism, hypermagnesemia, hyponatremia or hypernatremia, severe hemolytic disease, anemia, and polycythemia Table 4. [ncbi.nlm.nih.gov]

Neurologic

  • Lethargy

    Lethargy Being breathless and working hard causes discomfort and agitation. Also reserved energy fro work of breathing. Tachycardia to assist in oxygen transport. Hypoxemia reduced ability to oxygenate. [physio-pedia.com]

    As atelectasis and respiratory failure progress, symptoms worsen, with cyanosis, lethargy, irregular breathing, and apnea. [msdmanuals.com]

  • Apathy

    […] since September 11, 2001. hi यदि आत्मनिरीक्षण प्रशासन के प्रति पार्टी के दृष्टिकोण में कोई ओस बदलव नहीं ल पाया तो यकीन मानिए, जैसा परिणाम विधानसभा चुनावों का रहा है वैसा ढाई साल बाद लकसभा चुनाव में भी मिल सकता en My main message is: if we can redefine apathy [hi.glosbe.com]

Workup

The workup is based on history and physicial examination followed by imaging and endoscopy, while histologic examination is used to confirm the diagnosis of GI polyposis. Endoscopic morphologic findings are not specific. [dermatologyadvisor.com]

See Workup for more detail. [emedicine.medscape.com]

X-Ray

  • Bilateral Pulmonary Infiltrates

    He had an acute and rapidly progressive pulmonary disease, in association with progressive, diffuse, bilateral pulmonary infiltrates on the chest radiograph, and hypoxemia(PaO2/FiO2 ratio of 98.2 with PEEP) without evidence of cardiac disease. [reportworld.co.kr]

    These criteria are: rapidly progressive respiratory failure, severe hypoxemia (PaO2/FiO2 < 200), and evidence of bilateral pulmonary infiltrate on chest radiography. We estimate 40-50 patients will meet criteria. [clinicaltrials.gov]

    Bilateral pulmonary infiltrate 4. [slideshare.net]

    In a recent study, F igueroa -C asas et al. [ 72 ] evaluated the diagnostic accuracy of chest radiography to identify bilateral pulmonary infiltrates compatible with the diagnosis of ARDS, using CT as the reference standard. [err.ersjournals.com]

    The condition rapidly progresses to profound hypoxemia with bilateral pulmonary infiltrates on CXR and almost invariably requires mechanical ventilation. [cancertherapyadvisor.com]

Treatment

Clinical experience seems to justify surfactant treatment in neonates with ARDS. [ncbi.nlm.nih.gov]

Standard Therapies Treatment of infant respiratory distress syndrome consists of mechanical or physical breathing assistance such as positive end expiratory pressure (PEEP). Other treatment is symptomatic and supportive. [rarediseases.org]

Statistically there is a highly significant difference between Surfactant treatment group and not given surfactant treatment group (p < 0.01). [jemds.com]

Evidence suggests early treatment within 2 hours of delivery is more beneficial than if treatment is delayed. They'll also be given fluids and nutrition through a tube connected to a vein. [nhs.uk]

[…] a complication of the treatment is Figure C 5 The chest x-ray would reveal ground glass opacities and the fundoscopic image depicting a complication of the treatment is Figure B M1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (M1.PL.75 [medbullets.com]

Prognosis

Definition / general Rare, nonhereditary polyposis syndrome of unknown etiology Disorder of middle adulthood, with mean age of diagnosis of 59 years Poor prognosis due to associated nutritional complications Up to 50% have remissions Rarely has a fulminant [pathologyoutlines.com]

The prognosis is much better for babies weighing over 1500 g. Prevention Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation. [patient.info]

Indirect (source isn’t the lungs): capillary membrane is INDIRECTLY damaged due to a systemic inflammatory response system (SIRS) by the immune system: *Sepsis (most common and very poor prognosis for patients who have gram-negative bacteria) Burns Blood [youtube.com]

This case argues against the poor prognosis previously ascribed to patients with this syndrome. gastrointestinal system endoscopy View Full Text Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use [casereports.bmj.com]

Etiology

In this chapter, we provide a succinct overview of the history, etiology, risk factors, clinical manifestations, diagnosis, and management of CCS. [mayoclinic.pure.elsevier.com]

Mental stress and physical fatigue may also contribute to the etiology. [dermatologyadvisor.com]

Etiology The causes of ARDS can result from direct lung injury, termed pulmonary ARDS, or extrapulmonary where the triggering insult is outside of the lungs. These two etiological subtypes respond in different ways to mechanical ventilation. [radiopaedia.org]

For patients in the observed group infectious etiology was Introduction White dot syndrome comprises a heterogeneous group of autoimmune diseases of a noninfectious etiology that affect the choriocapillaris, pigment epithelium and the exterior layers [yumpu.com]

Published on May 25, 2018 In this video, the viewer will learn the differential diagnosis for newborn respiratory distress, and the epidemiology, pathophysiology, presentation, diagnosis, and management of its most common etiologies. [youtube.com]

Epidemiology

This reinforces the importance of using PALICC criteria moving forward for future epidemiologic studies of PARDS. [atm.amegroups.com]

[…] the result of a scientific and technical-logistical effort that lasted over two years”, explained Giorgio Conti, “which included repeated meetings and which, at the same time, extended the project to a second phase aimed at describing clinical course, epidemiology [researchitaly.it]

Published on May 25, 2018 In this video, the viewer will learn the differential diagnosis for newborn respiratory distress, and the epidemiology, pathophysiology, presentation, diagnosis, and management of its most common etiologies. [youtube.com]

Epidemiological history was positive for upper respiratory tract infection. Personal history revealed that she had been prenatally diagnosed with omphalocele. [signavitae.com]

Epidemiology of death in the PICU at five U.S. teaching hospitals. Crit Care Med 2014; 42:2101–2108 [PMC free article] [PubMed] [Google Scholar] 11. Quasney MW, Lopez-Fernandez YM, Santschi M, et al. [ncbi.nlm.nih.gov]

Pathophysiology

The pathophysiology of respiratory failure in preterm infants is characterized by a combination of primary surfactant deficiency and surfactant inactivation as a result of plasma proteins leaking into the airways from areas of epithelial disruption and [ncbi.nlm.nih.gov]

This paper reviews the pathophysiology of ARDS and the management of paediatric patients with acute lung injury. [jpnim.com]

Prevention

The best way of preventing HMD is by preventing a preterm birth. [childrenshospital.org]

Abstract The reversal of lung collapse is one of the challenges of lung injury prevention in pediatric acute respiratory distress syndrome. [ncbi.nlm.nih.gov]

Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. [medlineplus.gov]

Prevention The vast majority of babies who develop RDS do so because they are premature. Attempts to prevent early delivery are therefore a major consideration. A number of strategies can be used. [nursingtimes.net]

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