【医学课件】新生儿呼吸系统疾病(英文版)
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呼吸系统疾病(英文)页PPT文档
Respiratory Infections
The most frequent infections of childhood: 68/year
Pathogens:viruses,bacterial, other pathogens Host and environmental factors Classification of respiratory infections
Based on anatomy or X-ray manifestation
Bronchopneumonia Lobar or Lobular Pneumonia Interstitial Pneumonia
Pneumonia
Enmei Liu Children’s Hospital, CMU
Case -1
Jack, age four months, is sent at home by his general practitioner because of two days of rapid, laboured breathing and poor feeding. He was born at 27 weeks’ gestation, birth weight 979g and was discharged home at three months of age. On examination he was a fever of 37.4C and a respiratory rate of 60 breaths/min. His chest is hyperinflated with marked intercoatal recession. On auscultation there are generalized fine crackles and wheezes.
儿童呼吸系统疾病英文版
Pneumonia
therapy
Antimicrobial therapy
PG given by IM or IV PG-allergic: erythromycin clindamycin PG-resistent: cephalosporin
PG and cephalosporin-resistent: vancomycin
Course Agent
Acute
< 1 month
Progressive 1-3 months
Chronic >3 months
Pneumonia
classification
State of Illness
Mild
Severe
Pneumonia
the clinical manifestations of bronchopneumonia
Etiologic Agent
Infectious
Noninfectious
virus bacterial
foreign body aspiration
Mycoplasma(支原体肺炎)
chlamydial （衣原体肺炎）
fungi pneumocystis(肺囊
虫)
Pneumonia
classification
Pneumonia
therapy
Supportive Measures
control cough and dyspnea
keep airway clear
give oxygen
position: semi-reclining
Pneumonia
Nursing Diagnosis
小儿呼吸系统疾病-中英文ppt课件
1:3-4
2-3y
25-30 100-120
1:3-4
4-7y
20-25 80-100
1:4
8-14y
18-20
70-90
1:4
表：各年龄小儿呼吸、脉搏次数（每分钟） 可编辑课件PPT
婴幼儿－－腹膈式呼吸 年长儿－－胸腹式呼吸
呼吸中枢不完善 出现节律不齐 早产儿、新生儿更甚
可编辑课件PPT
肺活量：小，约50-70ml/kg，安静时年长儿 用12.5%的肺活量来呼吸，婴儿为30%±（一 次深吸气后最大呼气量）
➢ 鼻是呼吸道的起始部，也是嗅觉器官
可编辑课件PPT
➢ 由外鼻、鼻腔和鼻旁窦三部分组成
Nose pharynx ministry and pharynx -1
咽部狭小及垂直,富于淋巴组织 鼻咽扁桃体：在4个月即发育 增殖体过大，称为增殖体肥大 腭扁桃体：在1岁末逐渐退化
可编辑课件PPT
Nose pharynx ministry and pharynx -2
➢ 扁桃体炎多发生在年长儿 ➢ 扁桃体有防御及免疫功能 ➢ 单纯肥大者不宜手术切除 ➢ 慢性感染者则可手术摘除
可编辑课件PPT
Nose pharynx ministry and pharynx -3
➢ 小儿咽后壁间隙组织疏松 ➢ 有颗粒型的淋巴滤泡，1岁内最明显 ➢ 婴儿期发生咽后壁脓肿最多
可编辑课件PPT
Respiratory disease
可编辑课件Prequirements
Pediatric breathing system anatomy physiology characteristic
Expounding two special upper respiratory tract infection causes
2-3y
25-30 100-120
1:3-4
4-7y
20-25 80-100
1:4
8-14y
18-20
70-90
1:4
表：各年龄小儿呼吸、脉搏次数（每分钟） 可编辑课件PPT
婴幼儿－－腹膈式呼吸 年长儿－－胸腹式呼吸
呼吸中枢不完善 出现节律不齐 早产儿、新生儿更甚
可编辑课件PPT
肺活量：小，约50-70ml/kg，安静时年长儿 用12.5%的肺活量来呼吸，婴儿为30%±（一 次深吸气后最大呼气量）
➢ 鼻是呼吸道的起始部，也是嗅觉器官
可编辑课件PPT
➢ 由外鼻、鼻腔和鼻旁窦三部分组成
Nose pharynx ministry and pharynx -1
咽部狭小及垂直,富于淋巴组织 鼻咽扁桃体：在4个月即发育 增殖体过大，称为增殖体肥大 腭扁桃体：在1岁末逐渐退化
可编辑课件PPT
Nose pharynx ministry and pharynx -2
➢ 扁桃体炎多发生在年长儿 ➢ 扁桃体有防御及免疫功能 ➢ 单纯肥大者不宜手术切除 ➢ 慢性感染者则可手术摘除
可编辑课件PPT
Nose pharynx ministry and pharynx -3
➢ 小儿咽后壁间隙组织疏松 ➢ 有颗粒型的淋巴滤泡，1岁内最明显 ➢ 婴儿期发生咽后壁脓肿最多
可编辑课件PPT
Respiratory disease
可编辑课件Prequirements
Pediatric breathing system anatomy physiology characteristic
Expounding two special upper respiratory tract infection causes
小儿呼吸疾病(英文ppt)
Infection Diseases of Respiratory System in Children
Introduction
High Morbidity Rate High Mortality Rate
Each year, respiratory infection diseases cause about 15 million deaths among children younger than age 5 year through the world. Pediatric pulmonary infection accounts for about 63.89% of all hospitalizations of children, in which 44.6 percent are pneumonia.
Bronchial asthma, nephritis, myocarditis,
measles and pertussis may also follow AURI
Etiology
Rhinovirus Echo virus Coxsackievirus Parainfluenza
90% of AURI are caused by viral infection
“Common cold”
Introduction
80-90% proportion of visit to clinic.
spread to nearby organs and tissues
(otitis media, conjunctivitis, lymphadenitis, lymphadenitis and pneumonia)
Small
Introduction
High Morbidity Rate High Mortality Rate
Each year, respiratory infection diseases cause about 15 million deaths among children younger than age 5 year through the world. Pediatric pulmonary infection accounts for about 63.89% of all hospitalizations of children, in which 44.6 percent are pneumonia.
Bronchial asthma, nephritis, myocarditis,
measles and pertussis may also follow AURI
Etiology
Rhinovirus Echo virus Coxsackievirus Parainfluenza
90% of AURI are caused by viral infection
“Common cold”
Introduction
80-90% proportion of visit to clinic.
spread to nearby organs and tissues
(otitis media, conjunctivitis, lymphadenitis, lymphadenitis and pneumonia)
Small
【医学课件】新生儿呼吸系统疾病(英文版)
Bany getting worse, significant cyanosis, increased O2 reqirement
Blood gas: pH 7.185, PCO2 65, PO2 36, BE -18
ECHO: R-to-L shunting through the ductus arteriosus and foramen ovale, tricuspid regurgitation
right
Congenital diaphragmatic hernia
Can complicated with lung hypoplasia, Increased risk of PPHN and pneumothorax Should be intubated immediately after
Respiratory Diseases of
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
evidence of central cyanosis respiratory support vital signs: RR, HR, T, BP, SpO2
Physical examination
Blood gas: pH 7.185, PCO2 65, PO2 36, BE -18
ECHO: R-to-L shunting through the ductus arteriosus and foramen ovale, tricuspid regurgitation
right
Congenital diaphragmatic hernia
Can complicated with lung hypoplasia, Increased risk of PPHN and pneumothorax Should be intubated immediately after
Respiratory Diseases of
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
evidence of central cyanosis respiratory support vital signs: RR, HR, T, BP, SpO2
Physical examination
儿童呼吸系统疾病(英文版)PPT演示幻灯片
tachypnea:RR40~80ts/m
nasal flaring, sighing respiration, three depression signs and cyanosis
fixed fine moist rales
8
Pneumonia
the clinical manifestations of bronchopneumonia
Morphological classification
Lobar pneumonia Bronchopneumonia (lobular pneumonia) Interstitial pneumonia
6
Pneumonia
classification
Course Agent
Acute
< 1 month
The Lower Airway differences:
right bronchus is more wider, shorter, vertical less alveolar surface area
3
Pneumonia
Definition
An inflammation or infection of the bronchioles and alveolar spaces of the lungs
Pneumonia
manifestation
Severe bronchopneumonia
l digestive system
anorexia vomiting abdominal distention toxic enteritis
12
Pneumonia
manifestation
新生儿呼吸系统疾病(英文版)
Respiratory Diseases of
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
GBS prophylaxis
Focused respiratory history
Neonatal
umbilical cord blood gas condition at birth, including Apgar score resuscitation efforts required and response time of onset of symptoms, i.e., present from
Surfactant administration
Case 1 post surfactant
Case 1
Ventilation setting unchanged Baby deteriorated rapidly, increase
oxygen concentration from 40% to 100%, mottled, heart rate is 188 bpm, air entry on left side decreased
optimized?
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
GBS prophylaxis
Focused respiratory history
Neonatal
umbilical cord blood gas condition at birth, including Apgar score resuscitation efforts required and response time of onset of symptoms, i.e., present from
Surfactant administration
Case 1 post surfactant
Case 1
Ventilation setting unchanged Baby deteriorated rapidly, increase
oxygen concentration from 40% to 100%, mottled, heart rate is 188 bpm, air entry on left side decreased
optimized?
儿科学课件-呼吸系统英文版
DEFINITION
Bronchiolitis is an acute,
infectious, inflammatory disease of the lower respiratory tract resulting in obstruction of the small airways –bronchioli.
2+: Tonsils <50% of space between pillars
3+: Tonsils <75% of space between pillars 4+: Tonsils >75% of space between pillars
suppurative tonsillitis
The most common cause is bacterial infection of which the predominant is Group A β-hemolytic streptococcus (GABHS)
CHEST X-RAY
increased lung markings, slignt shadow in right lower lung
CASE 1
LAB
WBC 4.0109/L Hb 120g/L,PLT 323109/L Neutrophile 0.30 Lymphocyte 0.55 Monocyte 0.10
What do you find in the results?
Diagnosis
Acute Upper Respiratory Tract Infection (common cold)
CASE 2
13 years, girl chief complaint: Pharyngalgia and fever for four days
呼吸系统疾病基础知识概述(英文版)PPT课件( 81页)
respiratory distress
nasal flaring, retractions,cyonosis
rales
Severe symptomatic
Clinical manifestation
Cardiac muscle inflammation
circular system symptom
Drugs Physics methods
Febril convulsion
Calm Stop convulsion Defervesce
肺炎
Pneumonia
Pneumonia
In world,Occupy 1/3-1/4 in the death of children under
5 years of age
on typical of clinical manifestation
Typical pneumon来自auntypical pneumonia Severe acute respiratory syndrome,
(SARS) coronavirus
Classification 6
On Occurrence
The children’s repertory ability is low. The children’s local immunity is low.
Children Respiratory System Physiologic Feature
Respiratory rate
Neonate <1year 2-3years 4-7years 8-14years
Pneumonia is an inflammation of the parenchyma of the lungs
新生儿呼吸系统疾病PPT课件
25
发病机理
1. 脑血流变化： 缺氧：血流重分配，脑血管扩张，血流增加 加重：血压波动，脑血流量减少，脑缺血
2. 脑水肿：细胞毒性水肿、血管源性水肿 3. 脑代谢变化：
（1）无氧代谢：脑细胞变性、坏死 （2）氧自由基损伤：细胞膜裂解、坏死 （3）钙内流：细胞信息传递，能量代谢紊乱,死亡 （4）兴奋性神经递质：释放、细胞坏死 4. 小脑出血：早产儿多见、抑制症状 5. 脑室周围－脑室内出血（IVH）：早产儿多见
小脑幕下出血 抑制症状
2. 蛛网膜下腔出血：subarachoid hemorrhage
3. 脑实质出血：早产儿多见
35
出血部位
4. 小脑内出血
5. 脑室周－脑室内出血
（periventricular-
intraventricular
hemorrhage)
寂静型
重症
Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级
36
治疗
19
新生儿湿肺
(Wet lung disease)
一、病因
正常胎儿肺液：30ml / kg 正常肺液转运： 分娩时挤压、淋巴系统 转运障碍 ：发生湿肺
20
二、临床表现
呼吸增、困难、呻吟、青紫 数小时后缓解
三、胸片
肺内积液：肺泡、间质、叶间隙、胸膜腔
四、治疗
1. 吸氧 2. CPAP 3. 机械通气
动脉导管开放（PDA）的治疗
消炎痛：首剂0.2 mg /kg
第2、3剂 0.1mg /kg，q8h
维持内环境稳定
纠正酸中毒
保持正常血压
维持水电介质平衡
13
五、预防
产前: 孕母注射地塞米松 出生后： 气管内滴入PS
沐舒坦
发病机理
1. 脑血流变化： 缺氧：血流重分配，脑血管扩张，血流增加 加重：血压波动，脑血流量减少，脑缺血
2. 脑水肿：细胞毒性水肿、血管源性水肿 3. 脑代谢变化：
（1）无氧代谢：脑细胞变性、坏死 （2）氧自由基损伤：细胞膜裂解、坏死 （3）钙内流：细胞信息传递，能量代谢紊乱,死亡 （4）兴奋性神经递质：释放、细胞坏死 4. 小脑出血：早产儿多见、抑制症状 5. 脑室周围－脑室内出血（IVH）：早产儿多见
小脑幕下出血 抑制症状
2. 蛛网膜下腔出血：subarachoid hemorrhage
3. 脑实质出血：早产儿多见
35
出血部位
4. 小脑内出血
5. 脑室周－脑室内出血
（periventricular-
intraventricular
hemorrhage)
寂静型
重症
Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级
36
治疗
19
新生儿湿肺
(Wet lung disease)
一、病因
正常胎儿肺液：30ml / kg 正常肺液转运： 分娩时挤压、淋巴系统 转运障碍 ：发生湿肺
20
二、临床表现
呼吸增、困难、呻吟、青紫 数小时后缓解
三、胸片
肺内积液：肺泡、间质、叶间隙、胸膜腔
四、治疗
1. 吸氧 2. CPAP 3. 机械通气
动脉导管开放（PDA）的治疗
消炎痛：首剂0.2 mg /kg
第2、3剂 0.1mg /kg，q8h
维持内环境稳定
纠正酸中毒
保持正常血压
维持水电介质平衡
13
五、预防
产前: 孕母注射地塞米松 出生后： 气管内滴入PS
沐舒坦
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birth or developed after a period of normal respiratory function gestational age and birth weight
Physical examination
Observation
symmetry of chest movement indicators of laboured respiration skin colour and mucous membranes for
audible expiratory wheeze, crackles) presence of cleft palate or micrognathia (small
jaw)
Diagnostic tests
Chest radiograph Blood gases
Case 1
Born at 30 weeks gestation Apgar score 61, 85 Birth weight 1500 grams Developed signs of respiratory distress
evidence of central cyanosis respiratory support vital signs: RR, HR, T, BP, SpO2
Physical examination
Examination
Auscultation of breath sounds presence of grunting, inspiratory stridor,
Surfae 1 post surfactant
Case 1
Ventilation setting unchanged Baby deteriorated rapidly, increase
oxygen concentration from 40% to 100%, mottled, heart rate is 188 bpm, air entry on left side decreased
Case 1
Causes of sudden deterioration in a ventilated baby
D…displaced endotracheal tube? accidentally extubated or the tube too far in?
O…obstructed airway or endotracheal tube? P…pneumothorax or other critical diagnosis? E…equipment working and ventilation
GBS prophylaxis
Focused respiratory history
Neonatal
umbilical cord blood gas condition at birth, including Apgar score resuscitation efforts required and response time of onset of symptoms, i.e., present from
Lack of surfactant, resulting in progressive collapse of the alveoli
Primarily a disease of preterm babies; its incidence increases with decreasing gestational age.
at 30 minutes
Case 1
Pink RR 88/min and regular, HR 140 bpm Laboured respiration Well perfused, BP 47/25 mean 33 Tone normal Temperature 36.4°C
Case 1
Respiratory Diseases of
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
optimized?
Case 1
Management of symptomatic pneumothorax:
Chest tube insertion Needle aspiration
Case 2
Unremarkable pregnancy 38 weeks’ gestation Elective Caesarian Section Presented respiratory distress
Focused respiratory history
Intrapartum
fetal distress during labour and delivery presence of meconium stained liquor duration of rupture of membranes evidence of chorioamnionitis (maternal fever) nature of labour and route of delivery medications administration of intrapartum antibiotics for
Physical examination
Observation
symmetry of chest movement indicators of laboured respiration skin colour and mucous membranes for
audible expiratory wheeze, crackles) presence of cleft palate or micrognathia (small
jaw)
Diagnostic tests
Chest radiograph Blood gases
Case 1
Born at 30 weeks gestation Apgar score 61, 85 Birth weight 1500 grams Developed signs of respiratory distress
evidence of central cyanosis respiratory support vital signs: RR, HR, T, BP, SpO2
Physical examination
Examination
Auscultation of breath sounds presence of grunting, inspiratory stridor,
Surfae 1 post surfactant
Case 1
Ventilation setting unchanged Baby deteriorated rapidly, increase
oxygen concentration from 40% to 100%, mottled, heart rate is 188 bpm, air entry on left side decreased
Case 1
Causes of sudden deterioration in a ventilated baby
D…displaced endotracheal tube? accidentally extubated or the tube too far in?
O…obstructed airway or endotracheal tube? P…pneumothorax or other critical diagnosis? E…equipment working and ventilation
GBS prophylaxis
Focused respiratory history
Neonatal
umbilical cord blood gas condition at birth, including Apgar score resuscitation efforts required and response time of onset of symptoms, i.e., present from
Lack of surfactant, resulting in progressive collapse of the alveoli
Primarily a disease of preterm babies; its incidence increases with decreasing gestational age.
at 30 minutes
Case 1
Pink RR 88/min and regular, HR 140 bpm Laboured respiration Well perfused, BP 47/25 mean 33 Tone normal Temperature 36.4°C
Case 1
Respiratory Diseases of
Newborn
Focused respiratory history
Antepartum
gestation and accuracy of dates antenatal ultrasound findings maternal diabetes maternal Group B streptococcus (GBS) status administration of antenatal steroids maternal substance use family history of neonatal respiratory disorders
optimized?
Case 1
Management of symptomatic pneumothorax:
Chest tube insertion Needle aspiration
Case 2
Unremarkable pregnancy 38 weeks’ gestation Elective Caesarian Section Presented respiratory distress
Focused respiratory history
Intrapartum
fetal distress during labour and delivery presence of meconium stained liquor duration of rupture of membranes evidence of chorioamnionitis (maternal fever) nature of labour and route of delivery medications administration of intrapartum antibiotics for