Detresa respiratorie Destresa resp prin deficit
de surfactant – BMH
Orice dif resp <28z Insuf pulm la/ imd dupa n
Etio variata Deficit de surfactant
Tahipnee Tahipnee >60 RR
Sdr lupta resp Dispnee (tiraj, retractii)
Geamat Geamat exp
Tiraj Cianoza centrala
Batai aripi nazale Batai aripi nazale
Bombare toracica Resp paradoxala
Balans toraco abd
Apnee Debut 4-6h
Severit max 48h
Rezolutie 48-96h
Scor Silvermann
 Miscari resp Rx: de la nastere
 Retractie xifo Bronhograma aerica,
 Tiraj intercost opacitati nodulare dat de
 Geamat exp alveole colabate
 Batai aripi n Geam mat
>2 =detresa resp
Antenatal: raport lecitina/
sfingomielina >2 (normal)
Tratament:
-prevenirea nasterii prem
-CTER Beta/Dexa anten
-intarz clamparii cord omb
-O2 suplim (min FC>100)
Surfactant:
TTN
Intarz resorbtiei lich pulm
Tahipnee >100
Tiraj
Geamat
Uneori cianoza (revers O2)
Debut: primele 24h cu DR
Rx: aspect normal/ plaman
umed
Confort termic si O2
Evol fav rapida in 24h
Sdr asp meconiala
NN la termen/ postmaturi
hO2 intrauterina- elim de
meconiu in LA
Tahipnee
Tiraj
Geamat exp
Cianoza
Torace in butoi
DR
Rx: opacitati cu zone de
condensare pe ambele arii
pulmonare, separate de
zone de emfizem
D AP crescut
PTX, pneumomediastin
Tr
Prof : depistare
- Aspirare imediat
dupa expulzia capului
Curativ:
- Asp IOT, evit stim
- HTP: Viagra
- ATB: Ampi + Genta
-Curosurf 100-200mg/kg
-Survanta 4ml/kg
-Exosurf 5ml/kg

Complicatii:

-precoce
-tardive
Bronhodisplazia
pulmonara
Retinopatia prem
(fibrodisplazia retrolentala)
Sechele neuro de dif
gr