8
Pulmonary causes of tachypnea
Airway anomalies Choanal stenosis, atresia Laryngeal web Laryngotracheomalacia Bronchomalcia Subglottic stenosis
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Hypocalcemia
Sepsis
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12
Nonpulmonary causes of tachypnea
Miscellaneous Hyperthermia Hypothermia Narcotic withdrawal Pain Hirschsprung’s Large for gestational age-infant of diabetic mother (LGA-IDM) Trisomy-21
宫内生长迟缓 多胎妊娠
感染史（羊膜早破、母亲发热）
• 以往RDS史
胎儿窘迫、脐血pH、复苏情况
• 体检注意点
胎龄评估, 紫绀情况, 呼吸困难严重度, 呼
吸节律、呼吸次数, 全身情况（灌注, 心功
中枢）
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5
治疗原则
• 氧疗
CPAP及机械通气
Fio2>0.5 才能维持PaO2 50mmHg • 开放气道及气道物理治疗
• 置于中性环境温度，维持正常体温
• 容量及心功能维持 液体需24小时匀速输入
•抗菌素治疗
•病因学诊断 胸部X光片、血细胞计数、血气 血培养、透光试验
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6
Pulmonary causes of tachypnea
Mechanical (restrictive) Rib cage anomalies (asphyxiating thoracic dystrophy) Pneumothorax Pneumomediastinum Pleural effusion Chylothorax Severe abdominal distension
新生儿呼吸困难
孙眉月
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1
病因 分三类
肺部疾病 RDS、TTN、MAS、肺气漏、肺 炎、
肺出血、肺发育不良、慢性肺
Hale Waihona Puke 部疾病气道及肺阻塞性疾病 气道阻塞（喉气管软
化）、肺受压（膈疝）
非肺部疾病 先心、心功能不全、贫血、多
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血、低体温、窒息后
2
精品资料
• 你怎么称呼老师？
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11
Nonpulmonary causes of tachypnea
Neurologic
Postasphyxial state
Subarachnoid hemorrhage
Infections—meningitis
Metabolic
Metabolic acidosis
Hypoglycemia
9
Pulmonary causes of tachypnea
Parenchymal TTN,HMD Pulmonary edema Delayed maturation of epithelial sodium channel(ENaC) Aspiration syndromes-meconium, mucus, milk, blood Pneumonia Pneumatocele Pulmonary hemorrhage Interstitial pneumonitis
SPB deficiency, GBS pneumonia
respiratory distress
Oligohydramnios
Pulmonary hypoplasia
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14
Clinical history and diagnosis of causes for tachypnea (cont’)
PPHN
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10
Nonpulmonary causes of tachypnea
Cardiac Left-to-right shunt – pulmonary blood flow Congestive cardiac failure PDA Truncus Coarctation/interrupted aortic arch Atrioventricular (AV) canal AV malformation with high output failure
History
Likely diagnosis
Labor and delivery
Prolonged rupture of Sepsis, pneumonia
membranes (PROM)
Anesthesia/Analgesia Depression, apnea, cynosis
• 如果老师最后没有总结一节课的重点的难点，你 是否会认为老师的教学方法需要改进？
• 你所经历的课堂，是讲座式还是讨论式？ • 教师的教鞭
• “不怕太阳晒，也不怕那风雨狂，只怕先生骂我 笨，没有学问无颜见爹娘 ……”
• “太阳当空照，花儿对我笑，小鸟说早早早……”
• 病史注意点
妊娠周龄
母亲情况 糖尿病 产前大出血
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13
Clinical history and diagnosis of causes for tachypnea
History
Likely diagnosis
Maternal history
Diabetes CHD
TTN, RDS,hypoglycemia, LGA,
Asthma
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7
Pulmonary causes of tachypnea
Developmental abnormality TEF CCAM CDH Sequestration Pulmonary hypoplasia Lobar emphysema Lung cyst
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TTN
Drugs
Narcotic withdrawal
Pregnancy induced (IUGR),
Intrauterine growth retardation
hypertension (PIH) polycythemia, hypoglycemia
Polyhydramnios
TEF
Previous sibling with