A 1-hour-old boy is admitted to the neonatal intensive care unit for respiratory failure. The infant was born to a 27-year-old mother, gravida 4 para 2, at 29 weeks gestation via cesarean delivery due to maternal preeclampsia with severe features. Amniotic fluid was clear. Apgar scores were 7 and 8 at 1 and 5 minutes, respectively. Birth weight is 1,120 g (2 lb 8 oz). Temperature is 36.9 C (98.4 F), pulse is 170/min, and respirations are 56/min. Pulse oximetry is 82% on room air. There are intercostal and subcostal retractions. Cardiac examination shows tachycardia without murmurs. The lungs have decreased breath sounds bilaterally. The abdomen is soft without organomegaly. Surfactant is ordered, and the team prepares for intubation. Prior to these clinical interventions, which of the following best describes the condition of this patient's lungs compared to a normal neonate?

Question

A 1-hour-old boy is admitted to the neonatal intensive care unit for respiratory failure.  The infant was born to a 27-year-old mother, gravida 4 para 2, at 29 weeks gestation via cesarean delivery due to maternal preeclampsia with severe features.  Amniotic fluid was clear.  Apgar scores were 7 and 8 at 1 and 5 minutes, respectively.  Birth weight is 1,120 g (2 lb 8 oz).  Temperature is 36.9 C (98.4 F), pulse is 170/min, and respirations are 56/min.  Pulse oximetry is 82% on room air.  There are intercostal and subcostal retractions.  Cardiac examination shows tachycardia without murmurs.  The lungs have decreased breath sounds bilaterally.  The abdomen is soft without organomegaly.  Surfactant is ordered, and the team prepares for intubation.  Prior to these clinical interventions, which of the following best describes the condition of this patient's lungs compared to a normal neonate?

Quizplus · Accepted Answer

Eductional Objective: Respiratory distress syndrome classically presents in premature infants with increased work of breathing and hypoxia at birth due to surfactant deficiency.  Poor alveolar compliance leads to widespread atelectasis and decreased functional residual capacity.  Airway resistance is often increased due to lung inflammation and edema.

A 1-Hour-Old Boy Is Admitted to the Neonatal Intensive Care