Diagnosis of other lung conditions in premature babiesDDiagnosis of other lung conditions in premature babiesDiagnosis of other lung conditions in premature babiesEnglishNeonatology;RespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemNAPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPCJaques Belik, MD, FRCPC11.000000000000047.00000000000001178.00000000000Flat ContentHealth A-Z<p>Learn about how pneumothorax, pneumonia, and congenital lung defects are diagnosed. Trusted answers from Canadian Paediatric Hospitals.</p><p>Other lung conditions include pneumothorax, pneumonia, congenital diaphragmatic hernia, cystic adenomatous malformations, congenital lobar emphysema, pulmonary sequestration and pulmonary hypoplasia. Most of these lung conditions are best diagnosed with a chest X-ray.</p><h2>Key points</h2> <ul><li>The signs and symptoms of most other lung conditions will vary depending on the severity of the condition, and are best diagnosed with a chest X-ray.</li</li></ul>
Diagnostic d’autres pathologies des poumonsDDiagnostic d’autres pathologies des poumonsDiagnosis of other lung conditions in premature babiesFrenchNeonatology;RespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemNAPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPCJaques Belik, MD, FRCPC11.000000000000047.00000000000001178.00000000000Flat ContentHealth A-Z<p>Apprenez comment le pneumothorax, la pneumonie et des malformations congénitales des poumons sont diagnostiqués. Des réponses de la part d’hôpitaux pédiatriques canadiens fiables.</p><p>D’autres pathologies des poumons comprennent le pneumothorax, la pneumonie, l’hernie diaphragmatique congénitale, les malformations kystiques adénomatoïdes, l’emphysème lobulaire congénital, la séquestration pulmonaire et l’hypoplasie pulmonaire. La plupart de ces pathologies sont diagnostiquées à l’aide de radiographies pulmonaires.</p><h2>À retenir</h2> <ul><li>Les symptômes de la plupart des autres pathologies pulmonaires seront différents en fonction de la gravité de la maladie et on les diagnostique plus facilement à l’aide d’une radiographie pulmonaire.</li></ul>

 

 

Diagnosis of other lung conditions in premature babies1799.00000000000Diagnosis of other lung conditions in premature babiesDiagnosis of other lung conditions in premature babiesDEnglishNeonatology;RespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemNAPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPCJaques Belik, MD, FRCPC11.000000000000047.00000000000001178.00000000000Flat ContentHealth A-Z<p>Learn about how pneumothorax, pneumonia, and congenital lung defects are diagnosed. Trusted answers from Canadian Paediatric Hospitals.</p><p>Other lung conditions include pneumothorax, pneumonia, congenital diaphragmatic hernia, cystic adenomatous malformations, congenital lobar emphysema, pulmonary sequestration and pulmonary hypoplasia. Most of these lung conditions are best diagnosed with a chest X-ray.</p><h2>Key points</h2> <ul><li>The signs and symptoms of most other lung conditions will vary depending on the severity of the condition, and are best diagnosed with a chest X-ray.</li</li></ul><h2>Diagnosis of pneumothorax</h2><p>How easily a pneumothorax can be diagnosed often has to do with the rate of the air leak and the build-up of pressure within the chest. If the leak is small, the pneumothorax may not be noticed and the leak will likely seal itself up. If the leak is large, pressure will build-up within the chest and the pneumothorax will likely interfere with breathing, at times suddenly and dramatically.</p><p>Signs of a pneumothorax, which can come on quickly, include:</p><ul><li>a drop in oxygen levels in the blood</li><li>a corresponding drop in blood pressure and heart rate</li></ul><p>Sometimes a pneumothorax can be seen by shining a very bright light on the baby’s chest. Depending on the size and maturity of the baby, the light will penetrate through the chest wall and patches of air outside the lungs will appear to glow through the skin. A sample of the contents of the cavity may be taken with a needle to confirm the presence of air. Generally, however, a pneumothorax will be diagnosed or confirmed with a chest X-ray.</p> <figure class="asset-c-80"> <span class="asset-image-title">Pneumothorax X-ray</span><img src="https://assets.aboutkidshealth.ca/akhassets/Pneumothorax_XRAY_MEDIMG_PHO_EN.png" alt="" /><figcaption class="asset-image-caption">In the pneumothorax X-ray, there is increased blackness at the bottom of the right lung, and below the lung. The black appearance is due to the presence of free air within the cavity that surrounds the lung, known as the pleural cavity.</figcaption> </figure> <h2>Diagnosis of pneumonia</h2><p>Pneumonia is an infection of the lung. In other words, some foreign agent, usually bacteria, has somehow entered the lung and is interfering with the normal functioning of the lung.</p><p>Like respiratory distress syndrome (RDS), initial indications of pneumonia are tachypnea, indrawing, and cyanosis.</p><ul><li>Tachypnea, or rapid breathing, may indicate that the baby is working harder to eliminate the carbon dioxide in the blood, by increasing the frequency of breaths. Carbon dioxide is the product of breathing.</li><li>Grunting, or noisy breathing that sounds like a grunt, may occur. As the baby closes their glottis with each exhalation, they forcibly try to hold a little bit of volume in their lungs with each breath. The goal is to recruit some alveoli that may have become collapsed or filled with fluid by holding in small amounts of their breath. The noise produced is referred to as a “grunt.” However, many premature babies are not mature/strong enough to co-ordinate and produce this particular sign.</li><li>Indrawing is a powerful sucking in of the chest with each breath exposing the ribs beneath the skin. Indrawing often looks as if the chest wall is collapsing inward with each respiration and can be mild to severe.</li></ul><p>Other signs of pneumonia, such as a build-up of fluid in the lungs, can also have other causes. This can make diagnosis difficult. When infection is suspected, antibiotics are usually given before the infection has been confirmed. Although the signs of pneumonia are similar to other conditions, such as RDS, the staff at the Neonatal Intensive Care Unit (NICU) may have additional reasons to suspect an infection. For example, certain events during delivery, the condition of the mother during delivery, and indeed the type of delivery can put a newborn baby at risk for infection.</p><p>X-rays are not always helpful when diagnosing pneumonia. X-rays may turn up patchy areas of the lung, which can cover a large area or be very localized. Air bronchograms, or abnormal pockets of air sealed off from the rest of the lung, may also appear on X-ray. However, these signs are also present in RDS and transient tachypnea of the newborn (TTN), a condition where breathing becomes rapid for short periods of time due to failure of the lung fluid to become absorbed or expelled around the time of delivery. An baby with TTN may consume more surfactant than they are capable of making and therefore can develop secondary surfactant deficiency.</p><p>A good, or temporary response to surfactant replacement therapy may indicate pneumonia, since surfactant can be inactivated by the inflammation associated with infection. There may be a secondary surfactant deficiency due to the inflammatory process associated with pneumonia. Inflammation will also likely produce fluid in the lungs, which can also be detected.</p><h2>Diagnosis of congenital lung malformations</h2><p>Although rare, some premature babies are born with a congenital malformation of the lungs. These types of malformation may be suspected if the common non-specific signs of respiratory distress, such as increased breathing rate, grunting, or cyanosis, are present but unexplained in a premature baby. In other words, if lung function remains poor and other conditions such as infection or RDS have been ruled out, a malformation will be suspected. There may also be other signs that point to malformation. For example, if the malformation is large and severe, it may produce an abnormal shape on the outside of the body, which can be seen by the naked and trained eye.</p><p>Generally speaking, X-rays and other imaging techniques will be used to confirm a diagnosis of malformation. In most cases, the malformation is corrected with surgery.</p><p>There are many types of congenital lung malformations, the most common of which are discussed here.</p><h3>Congenital diaphragmatic hernia</h3><p>Congenital diaphragmatic hernia is a malformation of the diaphragm, which is the muscle that separates the chest from the abdomen. Usually with this condition, the diaphragm either is missing or has a hole in it. Consequently, the stomach, liver, and other organs in the abdomen can drift into the chest cavity, leaving little room for the lungs to expand during breathing.</p> <figure class="asset-c-80"> <span class="asset-image-title">Congenital diaphragmatic hernia X-ray</span><img src="https://assets.aboutkidshealth.ca/akhassets/Diaphragmatic_hernia_XRAY_MEDIMG_PHO_EN.png" alt="" /><figcaption class="asset-image-caption">The bowel has moved up into the left side of the chest, where the left lung would normally be seen. Bowel is not seen at all in the abdomen. The bowel pushes heart to the right and compresses the lungs leaving little room for them to expand during breathing.</figcaption> </figure> <h3>Cystic adenomatous malformations</h3><p>Cystic adenomatous malformations are cysts at the end of the small airways within the lung. There is a connection with the airways of the lung that causes the cysts to increase in size as more air enters the cysts but cannot get out. Most babies with cystic adenomatous malformation have respiratory distress. Cystic adenomatous malformations will appear on an X-ray as large air filled cysts.</p> <figure class="asset-c-80"> <span class="asset-image-title">Cystic adenomatoid malformation X-ray</span><img src="https://assets.aboutkidshealth.ca/akhassets/Cystic_adenomatoid_malformation_XRAY_MEDIMG_PHO_EN.png" alt="" /><figcaption class="asset-image-caption">In the cystic adenomatoid malformation X-ray, there is a bubbly pattern and some density in the left side of the chest. The bubbly pattern indicates large air filled cysts at the ends of small airways in the lung. The mass has pushed the trachea and heart to the right side.</figcaption> </figure> <h3>Congenital lobar emphysema</h3><p>Congenital lobar emphysema is a malformation which causes an overinflation of one of the lobes of the lungs. This becomes a problem since the overinflated lobe takes up more space than it should and therefore interferes with the regular inflation of the rest of the lung. This condition may cause the chest to inflate more on one side than the other.</p> <figure class="asset-c-80"> <span class="asset-image-title">Congenital Lobar Emphysema X-ray</span><img src="https://assets.aboutkidshealth.ca/akhassets/Congenital_lobar_emphysema_XRAY_MEDIMG_PHO_EN.png" alt="" /><figcaption class="asset-image-caption">In the congenital lobar emphysema X-ray, the right upper lung is overinflated and appears much darker. The black appearance is due to the presence of too much air in the lung. The lung pushes across the midline and shifts the heart to the left.</figcaption> </figure> <h3>Pulmonary sequestration</h3><p>Pulmonary sequestration refers to an area of non-functioning lung tissue that has no connection to the airways of the lung. The abnormality may be within the lung or outside the lung. A sequestration may cause breathing problems or may produce no symptoms at all.</p><h3>Pulmonary hypoplasia</h3><p>Pulmonary hypoplasia is underdevelopment of the alveoli, airways, and blood vessels of the lung. This abnormality can vary in severity. With more severe forms, the baby is unlikely to survive after birth.</p><p>More information</p> <ul><li> <a href="/Article?contentid=1766&language=English">Other lung conditions</a> </li><li> <a href="/Article?contentid=1837&language=English">Treatment of other lung conditions</a> </li></ul>https://assets.aboutkidshealth.ca/akhassets/Pneumothorax_XRAY_MEDIMG_PHO_EN.pngDiagnosis of other lung conditions in premature babies

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