Respiratory Management Flashcards

What is the primary goal of surfactant replacement therapy in premature neonates?

Answer: Decrease alveolar surface tension to prevent collapse

Surfactant reduces alveolar surface tension, preventing alveolar collapse and improving lung compliance in premature infants.

Which ventilator parameter is most directly adjusted to correct hypercapnia in a ventilated neonate?

Answer: Tidal volume or respiratory rate

Increasing tidal volume or respiratory rate increases minute ventilation, which removes more CO2 and corrects hypercapnia.

A term neonate has persistent tachypnea, grunting, and a chest X-ray showing fluid in the fissures. What is the most likely diagnosis?

Answer: Transient tachypnea of the newborn

Transient tachypnea of the newborn (TTN) classically presents with fluid in the interlobar fissures on CXR in term or late-preterm infants.

What is the recommended initial FiO2 for resuscitation of a term neonate at birth in the US?

Answer: 21%

Current NRP guidelines recommend starting resuscitation of term neonates with room air (21% FiO2) and titrating based on pulse oximetry.

Which finding on blood gas is most consistent with respiratory acidosis in a neonate?

Answer: pH 7.20, PaCO2 65 mmHg

Respiratory acidosis is characterized by a low pH combined with elevated PaCO2, reflecting inadequate ventilation.

High-frequency oscillatory ventilation (HFOV) is preferred in which neonatal condition?

Answer: Pulmonary interstitial emphysema (PIE)

HFOV is preferred in PIE because its small tidal volumes and high frequency minimize further barotrauma while maintaining gas exchange.