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Guide to Neonatal Ventilation Case Study 2

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Introduction

Introduction for Case 2 here

Objectives
Upon the completion of this module the learner will be able to:

  • Describe the etiology of meconium aspiration syndrome (MAS).
  • Discuss the pathophysiology of MAS and its effects on gas exchange and lung compliance.
  • Discuss the reasons for choosing ventilation modes in relation to disease processes.
  • Identify basic air leaks on a chest x-ray.
  • Discuss the use of iNO and how it affects the pulmonary vascular bed.

Case Study 2

  • Prenatal History (click to expand)
    • Baby B was born via emergency cesarean section at 39 6/7 weeks gestation to a 39-year-old Caucasian mother G5, P4, who presented late to care. Her first prenatal visit was at 39 3/7 weeks secondary to headaches and dizziness. She had a history of chronic hypertension and was diagnosed with preeclampsia and placental insufficiency; the fetus with intrauterine growth restriction. Induction of labor failed and a cesarean section was performed. Maternal laboratory studies were all normal. The mother’s blood type was O positive, Coombs (direct antiglobulin test [DAT]) negative.
      Apgar scores were 1, 4, and 7 at 1, 5, and 10 minutes respectively. The infant was covered in meconium. He cried initially after birth, then was apneic and floppy, needing suction, positive pressure ventilation (PPV), and oxygen. He recovered initially and was sent to the postpartum floor with his mother.

    • Guiding Questions
      1. What are the risk factors for MAS?
      2. What are the NRP guidelines regarding infants with meconium-stained fluid at delivery?


    • Learning Resources
  • Day of Life (DOL) 0-3 (click to expand)
    • Case information here

    • Guiding Questions
      1. What is the pathophysiology of MAS that causes respiratory distress?
      2. What are the common radiologic findings associated with MAS?
      3. What are the treatment strategies for the clinical management of MAS?
      4. What is the pathophysiology of the pneumomediastinum?
      5. What are the basic principles of and differences between HFOV and HFJV?
      6. How is the PCO2 affected by changing the settings on the HFJV?

    • Learning Resources
      • Blood Gases

      • MAS

      • Review of HFOV

      • Review of HFJV

      • e


  • Case Progression DOL xx
    • Case information here
    • Guiding Questions
      1. a
      2. b
      3. c
      4. d
      5. e
      6. f

    • Learning Resources
      • a
      • b
      • c
      • d
      • e


  • Case Progression DOL xx
    • Case information here
    • Guiding questions
      1. a
      2. b
      3. c
      4. d
      5. e
      6. f

    • Learning Resources
      • a
      • b
      • c
      • d

  • Case Progression DOL xx
    • Case information here
    • Guiding questions
    • Figures
    • Resources

  • CEU's
    • One
    • Two
    • Three
  • Practice Questions
    • Coming soon


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