Neonatal Respiratory Article Review

Instructions: 

Review of current medical journal or health issues containing 7-page article. The article should be on neonatal respiratory care or pediatric. The review must contain at least seven hundred words typed, 12 font Time Romans and one inch margins. Additionally, APA formatting style should be used in this review. The review must have article synopsis and a paragraph discussing student's opinion  of the article. 

In this blog, Respiratory Distress in the Newborn article is reviewed. 

Article synopsis

The article discusses ‘Respiratory Distress in the Newborn’ (Reuter et al., 2014). Respiratory distress is a common ailment affecting about 7% of all newborns.  Studies indicate that 15% and 29% of term infants and preterm admitted to the neonatal intensive care develop substantial respiratory morbidity (Reuter et al., 2014).Additionally, this even higher for infants prior to twenty-four weeks of gestation (Reuter et al., 2014). Particular risk factors upsurge the probability of the neonatal respiratory disease. These factors are MSAF (meconium-stained amniotic fluid), prematurity, maternal chorioamnionitis, and cesarean section delivery. Others include gestational diabetes, ultrasonographic results like structural lung abnormality and oligohydramnios abnormality. Predicting infants who are likely to become symptomatic are impossible before birth. Irrespective of the cause, if respiratory distress is not detected and properly managed, it may develop into cardiopulmonary arrest and respiratory failure. Hence, it is fundamental for any medical experts caring for newborns to identify its signs and symptoms. Moreover, they should classify several of its causes, and come up with management approaches to bar its complications or death.

Therapeutic and preventive strategies for a number of frequent causes of respiratory distress are well researched. When these therapeutic and preventive strategies are implemented, they can reduce the burden of respiratory distress. However, failure to detect signs and treat respiratory distress underlying cause in the newborn may result in both long-term and short-term complications such as respiratory failure, lung disease or death (Edwards et al., 2013).

Respiratory distress is detected in newborns as one or more symptoms of escalated work of breathing like grunting, nasal flaring, tachypnea and chest restrictions (Reuter et al., 2014). Usually, the respiratory rate of a healthy newborn is between thirty and sixty breaths per minute (Reuter et al., 2014). Tachypnea is characterized by respiratory rate over sixty breaths per minute. Tachypnea mechanism compensates for acidosis, hypoxemia, and hypercarbia. Pulmonary disease may initiate tachypnea, majorly in neonates.  Pulmonary edema, pneumonia, respiratory distress syndrome, and TTN (transient tachypnea of the newborn) reduce lung compliance which decreases the lung tidal volume. Therefore, to achieve satisfactory minute ventilation, the rate of respiratory must increase.

Escalated work of breathing due to the mismatched pulmonary mechanics from the upsurge airway resistance decreases lung compliance. Airway resistance results where there is airflow hindrance. The resistance is reduced by nasal flaring and this improves the work of breathing (Reuter et al., 2014). The restrictions are usually observed when there is the use of the accessory muscles, abdomen, sternum, neck and rib cage as a result of high resistance or lung compliance. Noisy breathing may airway resistance and it may assist in identifying airway obstruction. Stertor is recognized by snoring sound. It is heard over extrathoracic airways (Reuter et al., 2014). It shows nasopharyngeal blockage. Stridor is characterized by high-pitched breath sound. It indicates blockage in subglottic area, larynx, and glottis. Wheezing is like stridor. However, it is typically polyphonic. It is heard on expiration. It specifies tracheobronchial obstruction. Grunting is identified by the expiratory sound. It is triggered by the abrupt closure of the glottis during expiration in order to keep FRC (functional residual capacity), and also avert alveolar atelectasis.

Student’s opinion

Understanding ways of identifying respiratory distress in newborns and physiological abnormalities linked to each of its various causes would help in its optimal management. However, reducing its incidence through preventive strategies is appropriate, its early detection and treatment would reduce its short-term and long-term complications. Additionally, it will also reduce associated mortality of infants at risks. Consequently, this article equips readers with seven main objectives. It enables readers to apply the physical strategy in comprehending and detecting common causes of respiratory distress. Further, it allows the readers to differentiate pulmonary disease from cardiovascular, airway, and other respiratory distress cases in the newborns. Readers are also in a position to appreciate the risks linked to late preterm and early term, more so by cesarean section (Reuter et al., 2014). After reading this article, readers can easily identify clinical signs and radiographic patterns that reveal TTN, RDS (respiratory distress syndrome), MAS (meconium aspiration syndrome) and neonatal pneumonia (Reuter et al., 2014). The article enables the readers to determine long-term and short-term complications related to common neonatal respiratory disorders, encompassing chronic lung disease, tenacious pulmonary hypertension of the newborn, and pneumothorax (Reuter et al., 2014). The article also allows readers to recognize management approaches for MAS, pneumonia, RDS, and TTN. Finally, it enables readers to implement the current recommendations for the hindrance of MAS, RDS, and neonatal pneumonia.

References

Edwards, M., O., Kotecha, S., J., & Kotecha, S (2013). Respiratory distress of the term newborn infant. Paediatr Respir Rev, 14(1), 29-36.

Reuter, S., MD, Moser, C., MD, & Baack, M., MD (2014). Respiratory distress in new the newborn. Paediatric in Review, 35(10), 417-229.