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  • Respiratory Disorders












  • Respiratory Disorders

    Respiration is the process of transferring oxygen to the blood and carbon dioxide to the environment. Anatomical or physiological obstacles to this process are classified as respiratory disorders. Lung diseases can arise from airway constriction or defects in lung tissue. Hypoventilation from a low atmospheric oxygen density can also cause respiratory distress. Problems concerning the transfer of oxygen to the tissues are listed as cardiovascular disorders.

    Bronchiolitis

      Description

      An infectious disease primarily found in infants and toddlers. It affects the lower airways (bronchioles) causing inflammation. This results in swelling and an increase in mucus which may narrow or obstruct the airways.

      Cause

      It is a contagious disease, most commonly caused by respiratory syncytial virus (RSV), but may also be caused by other viruses such as parainfluenza and adenovirus.

      Signs and Symptoms

      The disease begins with cold-like symptoms such as runny nose, cough, decreased appetite, sneezing and slight fever.

      As it progresses the cough may become worse and the child may have increasing difficulty breathing. They display a faster rate of breathing and rib recession (a "sucking" in of ribs), and may also wheeze. Fever may continue, the child has a lack of appetite and if more severe, may show a blue color around the mouth and lips. Breathing is noisier than usual and vomiting may occur.

      Many will get only a mild form of the illness and display only the early cold-like signs and symptoms. However, some will require hospital care.

      Treatment

      Treatment at home is often all that is necessary after consulting the doctor. This may include: medication to control fever, keeping the child as quiet as possible, encourage drinking, an upright position and a humidifier may be recommended to improve breathing. If the child worsens, medical attention should be sought as hospitalisation may be required.

      In hospital the treatment may include the following depending on condition: oxygen to aid breathing, intravenous fluids if unable/unwilling to drink adequate amounts, humidification, and rest. Antibiotics are not effective against a virus, but may be given if there is a secondary infection such as an ear infection. A small percentage of patients may need mechanical ventilation (a respirator). If the cause is known to be RSV an aerosol medication may be given to shorten the disease. The illness usually lasts 7-10 days but hospitalisation is rarely required for the entire time.

      Prevention

      Avoid exposing the child to sick people as much as possible. Hand washing is the most effective means of preventing spread of the disease. Also avoid exposure to irritants such as cigarette smoke.

      There is a preventative medication available to high risk people, such as premature infants, those with cardiac or lung disease, and immunosupressed individuals.
    Hypoventilation

    Hypoventilation is defined as inadequate respiration, involving the transfer of oxygen (O2) to the blood and carbon dioxide (CO2) to the environment. This problem can arise for several reasons: lack of breathing control from the respiratory centers in the brain; lack of oxygen in the air; or poor diffusion of oxygen to the blood.

    Respiratory Distress Syndrome

    Respiratory distress syndrome (RDS), or hyaline membrane disease, occurs in premature babies who are born less than 35 weeks old. Their lungs have not yet developed surfactant, a substance that prevents the collapse of lungs. The rates of mortality in untreated babies are very high. Fortunately, recombinant or animal-based surfactant can be introduced into the baby's lungs to promote survival.

    Role of Surfactant: Surfactant is composed of 90% lipid, primarily dipalmitoylphosphatidylcholine (DPPC). The presence of surfactant reduces the surface tension of the alveoli.

    Whooping Cough

      Description

      Also known as Pertussis, whooping cough is a contagious respiratory infection which is characterized by paroxysms of coughing often followed by a "whooping" sound on inspiration. It affects any age group but is both more common, and more problmatic, for infants.

      Cause

      Whooping cough is caused by the Bordatella Pertussis bacteria. It is spread via the respiratory system through droplet infection. For example when the infected individual coughs or sneezes.

      Signs and Symptoms

      The infection may last for 6 weeks, although some residual coughing may occur for months afterwards in some cases. The signs and symptoms can be divided into three stages as follows;

      1. The Catarrhal Stage: Characterized by cold-like symptoms. Lack of appetite, runny nose, lethargy, and a hacking cough, especially at night. This is the most infectious stage and lasts 7-10 days.

      2. The Paroxysmal Stage: As suggested by the name, this stage is characterized by paroxysmal coughing. The infected person has several rapid coughs followed by an inspiratory whoop, and this may be repeated until the person vomits. Occasionally they may loose consciousness. During these uncontrollable coughing attacks the person will become red in the face, often followed by a bluish tinge as they are deprived of oxygen. In between episodes the individual seems fine. The coughing spasms may be brought on by exercise or laughing. This stage usually lasts 10-14 days but can last longer.

      3. The Convalescent Stage: During this stage, the coughing paroxysms become less severe and less frequent. This stage can last 2-4 weeks, although some coughing may remain for months.

      Treatment

      Treatment with antibiotics such as Erythromycin may shorten the duration of the illness. In many places, antibiotics will also be offered to the family of the ill person as a preventative measure.

      If severe (mostly infants), the person may require hospitalisation. These allows monitoring during attacks and intravenous hydration if required due to vomiting or decreased fluid intake. Oxygen and humidification may also occasionally be used. Some infants may stop breathing during coughing spasms.

      Prevention

      There is a vaccination for pertussis which helps to prevent the disease. The vaccine makes it much more unlikely for the individual to acquire the disease, but not impossible. However, if infected the illness will be milder and of shorter duration for an immunized person.




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