Ground glass appearance with bronchograms Homogenous, diffuse, bilateral reticulogranular pattern Air bronchograms with aerated bronchioles superimposed on non-aerated alveoli Volume loss Normal heart size Similar to GBS pneumonia
Causes pulmonary interstitial emphysema (PIE)
Inadequate surfactant secondary to prematurity --> atelectasis --> uneven distribution of pressure/gas to alveoli
What population does this normally occur in?
Long-term ventilator patients with uneven aeration and CLD
Transient tachypnea of the newborn (TTN)
Occurs when the lung fluid is retained; correlates with a decreased thoracic birth squeeze or diminished respiratory effort in the newborn
X-ray findings of TTN
Prominent perihilar streaking due to engorgement of blood vessels Hyperventilation caused by partial airway obstruction from mediastinal fluids * Fluid in the fissure especially fissure on the right that separates the lower/upper lobes (becomes more prominent with retained fluid present)
What is the hallmark of TTN?
Fluid in the fissure
What is the hallmark of sepsis over TTN?
Meconium aspiration x-ray findings
Snowstorm appearance Patchy and non-homogenous Prone to pneunothorax Increase in AP diameter Hyperventilation Atelectasis
Pneunomia/sepsis x-ray findings
Patchy infiltrates (aspiration) Bilateral diffuse granular pattern Streaky Loss of volume
What appears on transillumination of pneumothorax?
Positive transillumination with high intensity light
Congenital diaphragmatic hernia (CDH)
A condition of the displacement of the abdominal viscera into the thoracic activity
Why does CDH normally occur on the left?
80% involve the left hemidiaphragm through failure of the closure of the pleuroperitoneal canal during the 8th week of gestation
True or False. The earlier the onset of CDH the worse the outcome.
Respiratory distress in CDH is related to ...
The size of the defect and accompanying degree of pulmonary hyoplasia and pulmonary hypertension
Abdominal distention due to high pressure from CPAP
Treatment of CPAP
Gastric vented tube Time off CPAP Passage of stool
Bowel obstruction is most commonly seen where?
Bowel obstruction presents with
Bilious vomiting and abdominal distention
Duodenal atresia presents with
Non-bilious vomiting +/- distention
What is the hallmark of duodenal atresia?
What is duodenal atresia associated with?
True or False. Surgery is required for duodenal atresia.
What is signs of Hirschsprung's disease?
Failure to pass meconium in first 24 hours Vomiting and abdominal distention Dilated loops of bowel and air fluid levels Absence of ganglion cells in nerve plexus in colon Rectosigmoid junction but may involve entire colon
How is the diagnosis made for Hirschsprung's disease?
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