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Suggest Treatment For Pneumonia And Hyline Membrane Disease
Question: hi one of my relative's just born baby has HMD(hyline membrane disease 1st grade) after administration surfactant this xray done...then neonatologist told its picture about pneumonia...Need your advise on what course of treatment should take for better result. Doctor has told us to wait and watch for 72 hours.
Brief Answer:
More likely Broncho-Pneumonia
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day,
Dear Mr XXXXXXX
The X Ray provided by you shows hazziness in left lung field with doubtful air bronchogram suggestive of consolidation Pneumonia. The right lung field is clear.
Its more likely a clinical picture of Pneumonia. HMD produces such picture in both lung field and usually occurs in preterm babies especially below 30 weeks of age.
From the X ray , I could not find any endotracheal tube which means child is not on ventilator support.
I would require additional information
1. At what gestational age the baby was born
2. After how many hours of birth did the respiratory distress develop
3. Did the baby cry immediately after birth?
4. Was it normal or caesarean delivery?
Further management will depend on clinical assessment of baby.
If the respiratory distress is mild to moderate, baby is maintaining saturation on inhalation then it can be managed by antibiotics, supportive care and inhalational oxygen.
Baby will require following monitoring
1. Saturation of Oxygen monitoring by pulse oximeter
2. Daily Arterial blood gas analysis if there is no improvement
3. Daily Chest X ray to assess radiological improvement
Do get back to me with the details.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
More likely Broncho-Pneumonia
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day,
Dear Mr XXXXXXX
The X Ray provided by you shows hazziness in left lung field with doubtful air bronchogram suggestive of consolidation Pneumonia. The right lung field is clear.
Its more likely a clinical picture of Pneumonia. HMD produces such picture in both lung field and usually occurs in preterm babies especially below 30 weeks of age.
From the X ray , I could not find any endotracheal tube which means child is not on ventilator support.
I would require additional information
1. At what gestational age the baby was born
2. After how many hours of birth did the respiratory distress develop
3. Did the baby cry immediately after birth?
4. Was it normal or caesarean delivery?
Further management will depend on clinical assessment of baby.
If the respiratory distress is mild to moderate, baby is maintaining saturation on inhalation then it can be managed by antibiotics, supportive care and inhalational oxygen.
Baby will require following monitoring
1. Saturation of Oxygen monitoring by pulse oximeter
2. Daily Arterial blood gas analysis if there is no improvement
3. Daily Chest X ray to assess radiological improvement
Do get back to me with the details.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1)Gestational age by usg 36 week.... By LMP mother have 9 th month start.
2) after delivery baby cried immediately then after 5 minutes granting starts
4) baby from caesarean.
Spo2 maintain above 95
What is the recovery time?
Baby is on following antibiotics
Inj.Tazact 1.125 (cipla)
Inj.Mikacin 100 mg
In between use inj.dopamine for low bp
2) after delivery baby cried immediately then after 5 minutes granting starts
4) baby from caesarean.
Spo2 maintain above 95
What is the recovery time?
Baby is on following antibiotics
Inj.Tazact 1.125 (cipla)
Inj.Mikacin 100 mg
In between use inj.dopamine for low bp
Brief Answer:
Will take 2 to 3 days for improvement to be obviou
Detailed Answer:
Namasthe
Good morning
As the baby is born at 36 weeks which is nearing term it's very much less likely to be Hyaline membrane disease especially if the mother has received Steroids 24 hours prior to cesarean section.
Baby is maintaining saturation above 95 % which is very good indeed. It's likely to be due to Bronco pneumonia.
The baby will take at least 24 to 48 hours to improve after initiation of antibiotics
Following are the indicators for improvement
1. Vitals normal and no requirement of cardiotonic drugs like Dopamine
2. Respiratory rate decreasing and coming near to normal
3. Improvement in signs of respiratory distress like flaring of nose, chest retraction
4. Radiology improvement: Clearing of lung fields after taking repeat X ray
5. Decrease in supplemental Oxygen requirement
I would suggest you to discuss these things with your Pediatrician. The assessment is clinical and backed up by investigation. Also do consider repeating Xray in consultation with Treating Pediatrician.
If there is no much distress then feeds can be started (Expressed breast feed).
Do get back to me if you need any further assistance, will be glad to assist you.
Take care
Best Regards
Deepak
Will take 2 to 3 days for improvement to be obviou
Detailed Answer:
Namasthe
Good morning
As the baby is born at 36 weeks which is nearing term it's very much less likely to be Hyaline membrane disease especially if the mother has received Steroids 24 hours prior to cesarean section.
Baby is maintaining saturation above 95 % which is very good indeed. It's likely to be due to Bronco pneumonia.
The baby will take at least 24 to 48 hours to improve after initiation of antibiotics
Following are the indicators for improvement
1. Vitals normal and no requirement of cardiotonic drugs like Dopamine
2. Respiratory rate decreasing and coming near to normal
3. Improvement in signs of respiratory distress like flaring of nose, chest retraction
4. Radiology improvement: Clearing of lung fields after taking repeat X ray
5. Decrease in supplemental Oxygen requirement
I would suggest you to discuss these things with your Pediatrician. The assessment is clinical and backed up by investigation. Also do consider repeating Xray in consultation with Treating Pediatrician.
If there is no much distress then feeds can be started (Expressed breast feed).
Do get back to me if you need any further assistance, will be glad to assist you.
Take care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
respected sir,
present is the condition of baby. need your assessment.
1)Feeding increase from 5 cc to 10 cc
2) dopamine drip omit
3) color change being normal
4) meropenom inj starts
Dr. told tracheo bronchial Malasia.........
Only one thing resp rate fluctuating sometimes 60 sometimes 80
present is the condition of baby. need your assessment.
1)Feeding increase from 5 cc to 10 cc
2) dopamine drip omit
3) color change being normal
4) meropenom inj starts
Dr. told tracheo bronchial Malasia.........
Only one thing resp rate fluctuating sometimes 60 sometimes 80
Brief Answer:
Respiratory rate will normalize
Detailed Answer:
Dear Sir
That's really good indeed to hear. The baby is progressing well.
As colour is okay and cardiotonic support withdrawn it's good.
Respiratory rate will take some time to settle.
I hope baby is just on minimal support of oxygen through oxygen hood.
Do keep me posted.
Wishing you and your family a very happy and healthy life.
Regards
Deepak and family
Respiratory rate will normalize
Detailed Answer:
Dear Sir
That's really good indeed to hear. The baby is progressing well.
As colour is okay and cardiotonic support withdrawn it's good.
Respiratory rate will take some time to settle.
I hope baby is just on minimal support of oxygen through oxygen hood.
Do keep me posted.
Wishing you and your family a very happy and healthy life.
Regards
Deepak and family
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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