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Related Concept Videos

Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

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The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
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Breathing01:05

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The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
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Drug Dosing: Infants and Children01:29

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Pneumonia V: Nursing management and Prevention01:30

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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
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Related Experiment Video

Updated: Nov 18, 2025

Intratracheal Instillation of Stem Cells in Term Neonatal Rats
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Guidelines for surfactant replacement therapy in neonates.

Eugene H Ng1, Vibhuti Shah1

  • 1Canadian Paediatric Society, Fetus and Newborn Committee, Ottawa, Ontario.

Paediatrics & Child Health
|February 8, 2021
PubMed
Summary

Surfactant replacement therapy (SRT) is vital for neonates with respiratory distress syndrome (RDS). Prophylactic surfactant is not recommended with noninvasive ventilation, but early rescue surfactant is beneficial for worsening RDS.

Keywords:
Bronchopulmonary dysplasiaNeonatesNoninvasive ventilationPreterm infantsRespiratory distress syndromeSurfactant

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Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
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Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS

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Area of Science:

  • Neonatal Medicine
  • Pulmonology
  • Pediatric Critical Care

Background:

  • Surfactant replacement therapy (SRT) is crucial for managing neonatal respiratory distress syndrome (RDS), improving survival and reducing morbidities.
  • The rise of noninvasive ventilation for preterm infants has diminished the benefit of prophylactic surfactant administration.
  • Early rescue surfactant is indicated for infants with progressing RDS.

Purpose of the Study:

  • To review the current role and evolving strategies of surfactant replacement therapy in neonatal respiratory distress syndrome.
  • To discuss the shift from prophylactic to rescue surfactant administration in the context of noninvasive respiratory support.
  • To explore emerging noninvasive methods for surfactant delivery.

Main Methods:

  • Literature review of studies on surfactant replacement therapy in neonates with RDS.
  • Analysis of clinical practice guidelines and emerging research on surfactant administration techniques.
  • Evaluation of evidence for SRT in conditions beyond RDS.

Main Results:

  • Prophylactic surfactant is not beneficial when noninvasive ventilation is the primary support.
  • Early rescue surfactant administration is recommended for infants with worsening RDS.
  • Newer noninvasive surfactant delivery methods, including thin catheter, laryngeal mask airway, and nebulization, are under investigation.

Conclusions:

  • SRT remains a cornerstone in RDS management, with a paradigm shift towards early rescue therapy.
  • Noninvasive surfactant administration techniques are evolving, offering potential alternatives to traditional methods.
  • Limited evidence suggests SRT may benefit other neonatal respiratory conditions like meconium aspiration syndrome.