slides
7,8,10,11,12,14
7,8,10,11,12,14
what is bronchopulmonary dysplasia?
chronic obstructive lung disease in premature infants that survive the neonatal period
etiology unclear, thought to be due to trauma from neonatal care
what is epiglottitis
cellulitis of supraglottic structures
recurrent bronchitis may be an uncommon manifestation of what
asthma
what mutation do ALL patients have to have cystic fibrosis
mutations of both CFTR genes on the long arm of chromosome 7
what is the newest addition to routine care for patients with CF
twice daily nebulized hypertonic 7% saline
how long do infants with bronchopulmonary dysplasia have the illness?
first few years of life often requiring chronic oxygen and require recurrent rehospitalizations
what are the 4 d's to look out for that indicated epiglottitis (a life threatening emergency)
drooling, dyspnea, dysphagia, dysphonia
what is the hygeine hypothesis?
there is increasing evidence that asthma develops when the normal development of our immune system is delayed
the problem with CF is that it is a positive feedback loop, give in example of why
damaged airways lead to airway infection and poor airway clearance leading to excessive inflammation which leads back to damaged airways
what is the working hypothesis for aggressive nutritional therapy?
30 – 50% more calories will not only allow patients with CF to grow
normally, but will slow the progression of lung disease and therefore
significantly improve survival
what is the most common cause of cardiopulmonary arrest in pediatrics
respiratory failure
are foregin bodies in the upper or lower airway a true medical emergency
upper - may cause complete obstruction
what is the trend of patients with Cystic fibrosis
they are living longer into adulthood
what is a new problem in CF patients
obesity
what are common respiratory problems in children with neuromuscular disease?
cough insufficiency
restrictive lung disease
upper airway obtruction
aspiration
what anatomical and physiological differences between pediatrics and adults make children more susceptible to acute airway compromise?
larger head
prominent occupit w lax cervical support
relatively large tongue
narrow subglottic region
small airway diameter
what is asthma?
episodes of bronchospasm where airways narrow too much and too easily in response to stimuli
what is cystic fibrosis?
a genetic disorder in which the lungs and digestive system are clogged with muscus
what is the daily standard for CF
airway clearance
how do you manage children with chronic neuromuscular disease respiratory problems
improve airway clearance
minimize drooling
treat infections aggressively
maintain adequate oxygenation
ventilatory assistance
what is croup (laryngotracheobronchitis)
when is its peak incidence?
infection in upper airway
early fall and winter
what are clinical presentations of asthma
Recurrent episodes of wheezing.
• Troublesome cough at night.
• Cough or wheeze after exercise.
• Cough, wheeze or chest tightness
after exposure to airborne allergens or
pollutants.
• Colds “go to the chest” or take more
than 10 days to clear
what drugs are administered for CF
antibiotics
what are 4 ways to improve airway clearance
postural drainage
chest PT
enhance cough
bronchodialtors