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61

This dx is a congenital or acquired condition of excessive flaccidy of the laryngeal structures; specifically the epiglottis and arytenoids

Laryngomalacia

62

Laryngomalacia is associated with

-excessive flaccidy of the laryngeal structures -epiglottis -arytenoids

63

Cause of Laryngomalacia

-lack of neural control of laryngeal muscles or - from pressure on the laryngeal cartilage which leads to inadequate laryngeal rigidity and thus structural collapse during inspiration and exhalation

64

Bronchomalacia is seen in infants who had a prolonged stay

in the NICU

65

Key Difference b/w Laryngomalacia and Bronchomalacia:

-Laryngomalacia: congential -Bronchomalacia: NICU exposure

66

the cartilage of the major airways is weak, and when infants with this condition bear down, the airways can become partially/completely compressed. This is known as

bronchomalacia **generally associated with BPD

67

Retinopathy of prematurity (ROP) is a vasoproliferative retinopathy that occurs almost exclusively in

preterm infants in whom retinal vasculogenesis is incomplete

68

Most cited cause of ROP is exposure to

elevated tension of oxygen -injuring the developing retinal capillaries

69

Two phases of ROP:

phase 1 : oxygen toxicity to immature retina causes an arrest of normal vascularization phase 2: increased metabolic demand of the growing retina is met w/relative hypoxia caused by the paucity of blood vessels

70

ROP is classified into 5 stages of severity. What are the mildest and most severe forms?

stage 1 - mildest. a clear demarcation b/w vascular and avascular portions of the retina. stage 5 - most severe. complete retina detachment

71

TX for ROP

transscleral cryotherapy and laser photocoagulation

72

Cause for the most anxiety*** in children age 1-5yrs

Shy temperament

73

Just as RDS is a result of immaturity of the pulmonary system, apnea of prematurity (AOP) is a result of immaturity of the respiratory control centers in the newborn

brainstem

74

primary AOP (apnea of prematurity) versus central AOP. difference?

Primary - respiratory Central - neurological

75

the mainstay of drug therapy for AOP

Methylxanthines

76

Various forms of methylxanthines used include

aminophylline, caffeine, and caffeine citrate

77

Postanesthetic apnea is seen mostly in infants born

preterm (where preterm birth is defined as birth at <37 weeks of gestation)

78

one of the most significant risk factors for postanesthetic apnea

a hematocrit of less than 30%

79

the most common metabolic problem occurring in newborn infants ***

Hypoglycemia is

80

Many neonates whose serum glucose levels are at or just below the lower limits of the normal range are

asymptomatic

81

hypoglycemia in Infants with symptoms other than seizures should receive

an intravenous bolus of 2 mL/kg (200 mg/kg) of 10% dextrose.

82

If the hypoglycemic infant is experiencing convulsions, they should receive

an intravenous bolus of 4 mL/kg of 10% dextrose

83

Neonates risk factors for intraoperative hypoglycemia include:

-neonates who are are less than 48 hours old, -premature, or -small for gestational age, and in -those born to diabetic mothers,

84

for the preterm nb - Maintenance fluid requirements may be met with a glucose-containing solution of 5% dextrose in 0.2 normal saline 4 mL/kg/hr or 10% dextrose in water 2 to 3 mL/kg/hr to prevent intraoperative

hypoglycemia

85

Serum glucose concentrations in excess of 125 mg/dL can result in osmotic diuresis from glucosuria with subsequent dehydration as well as further release of insulin leading to

rebound hypoglycemia

86

• Hypocalcemia occurs in newborns for a variety of reasons, and in many cases, ionized calcium is decreased even as total calcium remains

within normal limits

87

• The clinical manifestations of hypocalcemia include

irritability, jitteriness, seizures, and lethargy

88

**Treatment with intravenous calcium should be considered for newborns who have

hypotension without an obvious cause

89

o Cases of bradycardia and even asystole have been seen with rapid intravenous administration

of calcium*** IV Calcium should be given over 5-10mins

90

o Intraoperative metabolic derangements such as alkalosis from hyperventilation and sodium bicarbonate administration can lead to hypocalcemia by

causing albumin binding of calcium that decreases ionized calcium concentration