A 41 week, 3.8 kg male infant is delivered via urgent c-section through meconium stained amniotic fluid secondary to non-reassuring fetal heart tones. He is meconium stained at delivery. Apgars are 1, 2, 5 and 7 at 1, 5, 10 and 15 minutes of life. He is admitted to the NICU intubated in 100% FiO2 with pre-ductal saturations 80-85% and post-ductal saturations 65-75%. He is on conventional ventilation with the following settings: PIP 25 PEEP 6 Rate 50 and i-time 0.3. There are copious meconium stained ETT secretions. An umbilical arterial catheter is placed and the following ABG is obtained: 7.01/70/30/16/-10. The CXR shows adequate expansion to 8-9 ribs with coarse, patchy, irregular pulmonary densities with scattered areas of consolidation. Surfactant is given with minimal improvement in oxygenation. His pre and post ductal oximeter trends remain unchanged. A follow-up ABG is obtained 30 minutes after surfactant: 7.05/60/25/16/-10. Which of the following should you order next?
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Classic clinical presentation of respiratory distress syndro…
Classic clinical presentation of respiratory distress syndrome includes:
An infant with a hoarse, weak cry needs to be evaluated for:
An infant with a hoarse, weak cry needs to be evaluated for:
A former 28 week infant is now 36 weeks PMA. The infant rema…
A former 28 week infant is now 36 weeks PMA. The infant remains on the ventilator and is consistently requiring greater than 50% FiO2. The CXR confirms evidence of parenchymal lung disease. Which classification of BPD would this infant be diagnosed with?
Which of the following is not a risk factor for developing b…
Which of the following is not a risk factor for developing bronchopulmonary dysplasia?
You are caring for an infant with transient tachypnea of the…
You are caring for an infant with transient tachypnea of the newborn. In discussing management needs with the nurse, you can confirm their understanding of the disease process by:
What is the desired PaO2 for a preterm infant?
What is the desired PaO2 for a preterm infant?
The diagnostic test that identifies congenital lobar emphyse…
The diagnostic test that identifies congenital lobar emphysema is:
You are taking a report on a new admit to the NICU. The infa…
You are taking a report on a new admit to the NICU. The infant is a 4 hour old 26 6/7 week 800 gram male infant delivered via cesarean delivery due to premature rupture of membranes with cervical dilation in a footling breech presentation. Labor progressed quickly, GBS unknown, and antenatal steroids were not given due to the maternal history of gestational diabetes. The infant was intubated in the delivery room, surfactant was administered, and placed on ventilator support. Based on this infant’s respiratory status, which of the following statements is true:
When treating pulmonary hypertension in an infant with BPD,…
When treating pulmonary hypertension in an infant with BPD, which of the following therapies is appropriate?