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Transient tachypnea of the newborn is a respiratory problem that can be seen in the newborn shortly after delivery. It is caused by retained fetal lung fluid due to impaired clearance mechanisms. [1] It is the most common cause of respiratory distress in term neonates.
The development of heated humidified high flow started in 1999 with Vapotherm introducing the concept of high flow use with race horses. [2]High flow was approved by the U.S. Food and Drug Administration in the early 2000s and used as an alternative to positive airway pressure for treatment of apnea of prematurity in neonates. [3]
Obstructive apnea may occur when the infant's neck is hyperflexed or conversely, hyperextended. It may also occur due to low pharyngeal muscle tone or to inflammation of the soft tissues, which can block the flow of air though the pharynx and vocal cords. [1] Central apnea occurs when there is a lack of respiratory effort.
Central sleep apnea is common in preterm, newborn, and infancy stages but a decrease in risk is found with aging and maturity of the central nervous system. Underlying neurological disorders are the most common cause of CSA in full term infants. Of the apnea related events in preterm infants born at less than 29 weeks, 25% are central in origin ...
Breath-holding spells (BHS) are the occurrence of episodic apnea in children, possibly associated with syncope (loss of consciousness and changes in postural tone).. Breath-holding spells occur in approximately 5% of the population with equal distribution between males and females.
The bag-valve-mask device has a self-inflating bag with a soft mask that rests on the face. When the bag is connected to an oxygen supply, the patient will receive 60 to 100% of inspired oxygen. The purpose of bag-valve-mask is to provide adequate temporary ventilation and allow the body to achieve airway control by itself.
Manifestations: When the newborn cries, there is a reversal of blood flow through the foramen ovale which causes the newborn to appear mildly cyanotic in the first few days of life. The heart rate of the newborn should be between 110 and 160 beats per minute and it is common for the heart rate to be irregular in the first few hours following birth.
As the disease progresses, the baby may develop ventilatory failure (rising carbon dioxide concentrations in the blood) and prolonged cessations of breathing ("apnea"). Whether treated or not, the clinical course for the acute disease lasts about two to three days. During the first day, the child worsens and requires more support.