Respiratory

Abstract

Respiratory is the first system-based chapter because adequate oxygenation and ventilation support are critical for stabilizing unwell or at-risk newborns. Respiratory distress is an early, common sign that stabilization is needed. Stabilization includes identifying infants who require intervention; applying the Respiratory Sequence; using a scoring tool to differentiate mild, moderate, or severe respiratory distress and organizing care accordingly; initiating stabilization measures; and monitoring. Related procedures (e.g., intubation), supportive technologies (e.g., continuous positive airway pressure and mechanical ventilation), and monitoring tools (e.g., pulse oximetry) are described. Respiratory conditions include transient tachypnea of the newborn, respiratory distress syndrome, aspiration syndromes, pneumonia, persistent pulmonary hypertension of the newborn, pneumothorax, and pulmonary hypoplasia. Specific diagnosis and management for each condition round out the chapter, with blood gas and chest radiograph interpretations as needed. Two case scenarios show different care pathways for mild, moderate, and severe respiratory distress.