Pediatric Pulmonary ppt:

Infant Respiratory Distress Syndrome (RDS) / Hyaline Membrane Disease

• Hyaline membrane disease is a severe lung injury in neonates linked to surfactant deficiency due to prematurity.
• Most prevalent in infants born before 28 weeks of gestation, reflecting insufficient lung development.
• Occurs primarily in premature infants but also in those born to diabetic mothers, multifetal pregnancies, via C-section, or with a family history of RDS.
• Key pathophysiology involves:
  • Surfactant - a mix of phospholipids and proteins critical for reducing alveolar surface tension to prevent collapse.
  • Increased surfactant production correlates with advancing gestational age.
• Clinical signs appear within minutes after birth, including:
  • Tachypnea, grunting, intercostal/subcostal retractions, nasal flaring, and dusky skin tone.
• Physical examination may reveal diminished breath sounds, fine rales, falling blood pressure, pallor, progressing to apnea and acidosis.
• Diagnosis involves clinical evaluation, chest X-ray showing "ground glass" appearances, and arterial blood gas analysis.

Differential Diagnosis of RDS

• Important considerations include:
  • Early-onset sepsis, pneumonia, cyanotic heart defects, persistent pulmonary hypertension, transient tachypnea of the newborn.

Prevention and Treatment of RDS

• Administration of betamethasone to mothers at risk of preterm delivery promotes surfactant production.
• Treatment strategies include:
  • Close monitoring and warm humidified oxygen.
  • Surfactant therapy post-intubation if needed.
  • Minimally invasive surfactant therapy (MIST) aims to reduce complications from traditional intubation.

Bronchiolitis

• An inflammation of the bronchioles primarily caused by viral infections, especially in infants under two years.
• Management focuses on hydration, oxygenation, and symptomatic treatment:
  • Routine use of bronchodilators and corticosteroids is discouraged.
  • Ribavirin reserved for severe cases.
• Prognosis is generally good, with many recovering within 3-5 days, although 40% may experience recurrent wheezing by age five.

Respiratory Syncytial Virus (RSV)

• Known as the leading cause of bronchiolitis and a significant contributor to infant mortality from viral infections.
• Most children are infected by age two, with severe cases seen in premature infants or those with underlying health conditions.
• Diagnosis is often made via rapid antigen tests.
• Complications such as otitis media (10-20%) and pneumonia (0.5-1%) can arise.

Pediatric Asthma

• A chronic inflammatory condition with episodic airway obstruction.
• Risk factors include environmental exposures and genetic predispositions, with a higher prevalence in males and lower socioeconomic groups.
• Symptoms include recurrent wheezing and coughing, often triggered by viral infections or allergens.
• Diagnosis is confirmed by spirometry showing variable airflow limitation and response to bronchodilators.

Croup (Laryngotracheobronchitis)

• Primarily caused by parainfluenza viruses, most common in children aged 3 months to 5 years.
• Characterized by a "barky" cough, hoarseness, and inspiratory stridor, often worsening at night.
• Diagnosis is clinical but can be confirmed with a "steeple sign" observed in x-rays.
• Management usually includes supportive care, cool mist, and corticosteroids for moderate to severe cases.

Acute Epiglottitis

• A rare but serious form of airway obstruction that presents suddenly with a high fever, sore throat, and drooling.
• Traditionally linked to Haemophilus influenzae type b; currently, most cases are due to other bacteria like Streptococcus species.
• Diagnosis requires careful visualization of the epiglottis in a controlled setting, avoiding agitation of the child.
• Immediate management includes ensuring airway patency, often requiring intubation and administering antibiotics.

Whooping Cough (Pertussis)

• Caused by Bordetella pertussis and prevented by vaccination; incidence has risen despite widespread immunization.
• Characterized by a paroxysmal cough, with infants often lacking the characteristic "whoop" due to their developmental stage.
• Diagnosis involves identifying leukocytosis with lymphocytosis and is confirmed with PCR testing.
• Treatment includes antibiotics to limit disease spread and hospital management for at-risk infants.

Cystic Fibrosis

• The most common autosomal recessive condition in Northern European populations, occurring in about 1 in 2000 to 3000 live births.
• Symptoms include chronic pulmonary infections, pancreatic insufficiency, and high sweat chloride levels.
• Diagnosis rests on genetic testing or demonstrating CFTR gene functionality.

This quiz explores the epidemiology of Respiratory Syncytial Virus (RSV), including its prevalence, high-risk populations, and impact on infants and adults. Learn about the significance of RSV as a leading cause of bronchiolitis and the statistics surrounding its infection rates. Test your knowledge on this crucial public health topic.