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RESPIRATORY DISORDER SYNDROME IN INFANTS
Tokhtayeva Dilfuza
Center for the development of professional
Qualifications of medical personnel.
2nd year director of the Department of Neonatology
https://doi.org/10.5281/zenodo.13736545
Respiratory diseases in children are divided into several groups, including
acute and chronic infectious-inflammatory diseases, allergic diseases, congenital
and hereditary diseases developed during infancy.
Acute and chronic infectious-inflammatory diseases include diseases of the
upper and lower respiratory organs. Rhinitis, pharyngitis, tonsillitis, otitis,
sinusitis, laryngitis are more common in the upper respiratory tract; lower
respiratory tract diseases include tracheitis, bronchitis (acute, chronic,
obstructive, recurrent), bronchiolitis, pneumonia, pleurisy, and bronchiectatic
diseases.
Allergic diseases can include bronchial asthma, diseases developed during
infancy, such as bronchopulmonary dysplasia, Wilson-Mikiti syndrome.
Hereditary diseases include a number of diseases such as idiopathic diffuse
fibrosis of the lungs, idiopathic pulmonary hypertension, alveolar microlithiasis
of the lungs, Kartagener's syndrome, cystic fibrosis, alpha-1 antitrypsin
deficiency.
The main task of the respiratory system is to supply the div with oxygen.
If any part of this system is damaged, the whole system can fail, which can cause
a lack of oxygen in the div (hypoxia) and subsequent irreversible processes.
If we dwell on the origin of hypoxia in the child's div, firstly, it depends on
the anatomical and physiological characteristics of the respiratory tract of the
child, and secondly, the respiratory tract is very sensitive and gives an
immediate hypersensitivity reaction to various infections, allergens or other
stimuli, causing shortness of breath and gasping, and endangering the child's
life. can give birth. All of the above-mentioned diseases are more or less life-
threatening for the child.
Acute broncho-obstruction, lung gas exchange disorder, shortness of breath
attack (asthmatic status) and other conditions are extremely dangerous for a
child's life as a result of acute respiratory failure.
Every year, 40 million babies in the world suffer from asphyxia. In
developed and developing countries, the frequency of its occurrence differs
sharply, that is, from 1 to 50 of every 1000 live births. According to WHO
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guidelines, it is the main cause of morbidity and mortality in developing
countries. 19% of the 5 million neonatal deaths each year are due to asphyxia
during childbirth.
Asphyxia of newborns is a syndrome characterized by cardiac arrest,
absence of breath or irregular, inefficient respiratory movements. The
conditional nature of the term is self-evident, as translated from Greek it means
"absence of pulse".
Asphyxia is a disorder of gas exchange, which leads to a decrease in the
amount of oxygen in the blood, an increase in the amount of carbon dioxide and
metabolic acidosis. Later, prolonged asphyxia leads to a decrease in systemic
pressure (hypotension) and ischemia of internal organs. Fetal hypoxia is the
leading cause of perinatal death.
60% of neonatal stillbirths and pathological factors leading to death occur
in the antenatal period and only 20% in the postpartum period. For a child with
chronic intrauterine hypoxia, the complications of childbirth are considered
particularly unpleasant, leading to a violation of the compensatory mechanism
and serious consequences. Perinatal hypoxia is the cause of 30-60% of central
nervous system injuries in fetuses and newborns, and the extent of pathological
abnormalities depends on the duration and severity of fetal hypoxia. Acute
asphyxia caused by intranatal factors is the most severe and the outcome is
unpleasant. But antenatal hypoxia does not always lead to acute asphyxia during
childbirth. Meconium is found in amniotic fluid in 15% of births, but 8-10 out of
100 such children experience meconium aspiration or fetal distress. Most babies
born with acute asphyxia have a combination of the factors listed above, but
there are 5 leading mechanisms that cause acute asphyxia in most newborns:
1) inadequate hemoperfusion of the maternal part of the placenta (in
particular, any hyper- or hypotensive syndrome in the mother);
2) deterioration of maternal blood oxygenation in case of anemia,
cardiovascular and respiratory failure in the mother;
3) violation of gas exchange during placental migration;
4) stoppage of blood flow through the umbilical system (knots, pressure,
falling of the umbilical cords);
5) the lack of the child's ability to breathe independently (developmental
defects, MNS damage, drug treatment of the mother, etc.)
It should be noted that there is no single diagnostic sign that reliably predicts
the birth of a child with intranatal asphyxia. For example, such a common
method as monitoring the number of heart contractions in the fetus
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(cardiotocography) did not give enough results, which was demonstrated in a
large number of tests. Therefore, even when a child with a good antenatal
history is born, it is necessary to prepare all equipment for resuscitation
measures.
References:
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Руководство по основам ухода за здоровым и больным
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Сепсис и синдром системного воспалительного ответа у детей:
учебно-методическое пособие . Т.Н. Самаль, А.П.Кудин- 3 -изд. - Минск
БГМУ, 2017
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