newborn nursing

in this clinical video we will see a newborn with respiratory distress and try to identify its clinical signs lets start with our case nasal flaring is not evident in our baby but tachypnea intercostal retractions sternal retractions and grunt are quite evident which signify that work of breathing is increased in this baby and this clinical scenario is associated with distal airway or lung parenchyma problem

in distal airway or lung parenchyma problem baby attempts to maintain alveolar volume by prolonging and increasing expiratory pressures by breathing against a partially closed glottis leading to grunting noise finally the rationale question is can we diagnose a clinical problem just by observing respiratory patterns in babies and the answer is yes

lets start one by one if you observe suprasternal and subcostal retractions think of upper airway obstruction presence of tachypnea without effort points towards cardiac problem if you see a baby with poor effort

compared with physiologic need think of neurodepression commonly seen in babies with birth asphyxia and finally in a setting of tachypnea,apnea,lethargy with minimal retractions think of metabolic acidosis of sepsis it should always be kept in mind that in clinical settings clinical correlation of patterns of neonatal respiratory effort is seen in early disease process before patterns merge with systemic disease process