Neonatal RDS

[BlackNDecker]

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Someone help me connect the dots here...

Decreased surfactant --> Increased surface tension ---> Increased collapsing pressure

Accompanied by:

Decreased ventilation w/ vasoconstriction ---> endothelial necrosis ---> fibrinous exudate and cellular debris ---> hyaline membrane dz ---> Increased collapsing pressure(via increased elastance)

Ok, so this makes sense, BUT pathologically characterized by dilated respiratory bronchioles & alveolar ducts 😕

 

[LAZYGUY]

dilation of the airways is usually secondary to obstruction or infection. In the case of NRDS: lack of surfactant --> microatelectasis --> injury and extravasation of fibrin (hyaline membranes). From my understanding the injury damages the supportive interstitium of the lower airways so that histopathologically they appear as dilated bronchioles with hyaline membranes. The dilation of the lower airways in NRDS is similar to that found in the bronchi in the cases of bronchiectasis. Hope that helps.

Someone help me connect the dots here...

Decreased surfactant --> Increased surface tension ---> Increased collapsing pressure

Accompanied by:

Decreased ventilation w/ vasoconstriction ---> endothelial necrosis ---> fibrinous exudate and cellular debris ---> hyaline membrane dz ---> Increased collapsing pressure(via increased elastance)

Ok, so this makes sense, BUT pathologically characterized by dilated respiratory bronchioles & alveolar ducts 😕

 

[BlackNDecker]

dilation of the airways is usually secondary to obstruction or infection. In the case of NRDS: lack of surfactant --> microatelectasis --> injury and extravasation of fibrin (hyaline membranes).

NRDS is neither an obstruction nor an infection...you probably knew that which is why I'm confused you made this parallel 😕

From my understanding the injury damages the supportive interstitium of the lower airways so that histopathologically they appear as dilated bronchioles with hyaline membranes. The dilation of the lower airways in NRDS is similar to that found in the bronchi in the cases of bronchiectasis. Hope that helps.

NRDS and bronchiectasis are quite disimilar. Bronchiectasis, an obstructive lung disorder, is an inflammatory condition marked by neutrophilic infiltrate which causes destruction of the connective tissue framework >>> increased compliance. NRDS, a restrictive lung disorder, is collapse of the lung due to increased surface tension, and the ensuing exudate(hyaline) would result in decreased compliance(clearly opposite physiologic phenomenon). In discussions in other forums, the consensus is that the lung collapses around the residual air in the nonfunctional air exchange units(i.e. alveoli, alveolar ducts, resp. bronchioles). It seems reasonable to conclude that the air is not resorbed because of the decr. diffusion thru the hyaline membranes.

Thanks anyways...

 

[LAZYGUY]

Look blackndecker: obviously there is no clear understanding why there is dilation in the bronchioles. If you want to be an dingus about it, then you did just that. I am not debating what is already understood as fact. You asked why there is bronchodilation and I put my understanding of the situation. I am not debating bronchiectasis and the pathophys behind NRDS. It seems others had good reason not to reply to your comments. 🙄

NRDS is neither an obstruction nor an infection...you probably knew that which is why I'm confused you made this parallel 😕




NRDS and bronchiectasis are quite disimilar. Bronchiectasis, an obstructive lung disorder, is an inflammatory condition marked by neutrophilic infiltrate which causes destruction of the connective tissue framework >>> increased compliance. NRDS, a restrictive lung disorder, is collapse of the lung due to increased surface tension, and the ensuing exudate(hyaline) would result in decreased compliance(clearly opposite physiologic phenomenon). In discussions in other forums, the consensus is that the lung collapses around the residual air in the nonfunctional air exchange units(i.e. alveoli, alveolar ducts, resp. bronchioles). It seems reasonable to conclude that the air is not resorbed because of the decr. diffusion thru the hyaline membranes.

Thanks anyways...

 

[BlackNDecker]

Look blackndecker: obviously there is no clear understanding why there is dilation in the bronchioles. If you want to be an dingus about it, then you did just that. I am not debating what is already understood as fact. You asked why there is bronchodilation and I put my understanding of the situation. I am not debating bronchiectasis and the pathophys behind NRDS. It seems others had good reason not to reply to your comments. 🙄

Somebody is a lil sensitive...do you always get this upset if someone disagrees with you?

I disagreed with your parallel, as it was physiologically opposite to NRDS. Someone(RS6, some lurker, etc.) may come along and dominate my arguement...if so, then I will learn something new. If anything, this gave you, me, and the SDN community an opportunity to learn bronchiectasis & NRDS a little better. What's wrong with debating the subject?

Theoretically, this forum should be "egoless" since NOBODY knows who you are. It makes no sense to get upset if someone disagrees with you.

 

[LAZYGUY]

ok, sorry my bad.....sometimes I can misinterpret posts

Somebody is a lil sensitive...do you always get this upset if someone disagrees with you?

I disagreed with your parallel, as it was physiologically opposite to NRDS. Someone(RS6, some lurker, etc.) may come along and dominate my arguement...if so, then I will learn something new. If anything, this gave you, me, and the SDN community an opportunity to learn bronchiectasis & NRDS a little better. What's wrong with debating the subject?

Theoretically, this forum should be "egoless" since NOBODY knows who you are. It makes no sense to get upset if someone disagrees with you.