When can one diagnose acute respiratory distress in a newborn?
High-Yield Explanation
(D) All of the abovePEDIATRIC CRITICAL CARE MEDICINE -2015 AgeExclude patients with peri-natal related lung diseaseTimingWithin 7 days of known clinical insultOrigin of EdemaRespiratory failure not fully explained by cardiac failure or fluid overloadChest ImagingChest imaging findings of new infiltrate(s) consistent with acute pulmonary parenchymal diseaseOxygenationNon-Invasive mechanical ventilationInvasive mechanical ventilationPARDS (No severity stratification)MildModerateSevereFull face-mask bi-level ventilation or CPAP >=5cmH2 O4<=OI<16OI>=16 PF ratio <3005<=OSI<7.57.5<=OSI<12.3OSI>=12.3Special PopulationsCyanotic Heart DiseaseStandard Criteria above for age, timing, origin of edema & chest imaging with an acute deterioration in oxygenatioin not explained by underlying cardiac disease.Chronic Lung DiseaseStandard Criteria above for age, timing and origin of edema with chest imaging consistent with new infiltrate and acute deterioration in oxygenation from baseline which meet oxygenation criteria above.Left Ventricular DysfunctionStandard Criteria for age, timing and origin of edema with chest imaging changes consistent with new infiltrate and acute deterioration in oxygenation which meet criteria above not explained by left ventricular dysfunction. PATHOPHYSIOLOGIC APPROACH TO CLINICAL CONDITIONS CAUSING RESPIRATORY DI$TRESSEtiologyPathophysiologyClinical conditionsInterference with air flow (entry or exit)*. Upper airway obstruction*. Acute laryngitis, laryngotracheitis, foreign body*. Lower airway obstruction*. Bronchiolitis, asthma*. Mechanical compression*. Large pleural effusion, pneumothorax*. Thoracic wall injuries*. Flail chestInterference with alveolar*. Failure of alveolar ventilation*. Pneumonia, pulmonary edemagas exchange*. Failure of diffusion*. Pneumonia, pulmonary edemaCardiovascular problems*. Mechanical or inadequate function*. Congestive cardiac failure, arrhythmias, myocarditis, pericarditis, Right-to-left shuntsCNS*. Depression of respiratory center*. Raised ICT*. Stimulation of respiratory center*. Acidosis, salicylate intoxication*. Neuromuscular impairment of respiration*. Acute paralytic poliomyelitis, Guillain-Barre Syndrome, organophosphate poisoning, snake bite, diaphragmatic paralysisOther*. Insufficient oxygen supply to tissues and/ or increased oxygen demands*. Sepsis, severe anemia, high altitude, carbon monoxide exposure, smoke inhalation, met-hemoglobinemia*. Compensation for metabolic acidosis*. Diabetic ketoacisosis, acute renal failure