PaedShots

🔻Why Too Much Oxygen Can Collapse the Lung (The Nitrogen Washout Mechanism)❓️❗️
📌​ Weaning FiO2 is essential to protect from or , but there is an immediate mechanical danger to high oxygen exposure (near 100\%) that every NICU clinician should monitor: ⚠️Absorption Atelectasis.
​How hyperoxia paradoxically destroys alveolar stability🤔:
​🔹 The Normal Lung Scaffold🫁:
▪️Ambient air is roughly 78% Nitrogen (N2) and 21% Oxygen (O2).
▪️Nitrogen is an inert gas that does not easily cross the alveolar-capillary membrane➡️ Because it stays behind, it exerts vital structural partial pressure that acts like a "splint," keeping the alveoli open at the end of expiration and maintaining Functional Residual Capacity (FRC).
​🔹 The "Washout" Effect:
▪️When a neonate is exposed to excessively high concentrations of oxygen, the sheer volume of O2 completely replaces and "washes out" the structural nitrogen from the alveoli.
​🔹 Alveolar Collapse:
▪️Unlike nitrogen, oxygen passes rapidly and easily into the pulmonary capillaries to bind with hemoglobin.
➡️If an alveolus is filled entirely with O2, the blood absorbs it faster than ventilation can replenish it.
➡️With zero inert nitrogen left behind to hold the framework open, ➡️the internal pressure drops, and the alveolus completely collapses (Atelectasis).

​⚠️ The Clinical Paradox:
▪️​This widespread collapse worsens ventilation-perfusion (V/Q) mismatch and increases right-to-left shunting.
➡️The result❓️
▪️Severe, paradoxical hypoxia—driven by the very oxygen intended to treat it.

​💡 Bedside Takeaways for the Team:
⭐️​Always use air-oxygen blenders:
▪️Avoid unblended 100% FiO2 bursts whenever possible.
▪️​Target safely: Titrate oxygen conservatively to maintain target saturations (typically 92–94% in preterm infants).
▪️​Recruit with pressure, not fraction: Optimize PEEP or CPAP to hold the FRC mechanically rather than relying on toxic levels of inspired gas.

Kawasaki disease

Fever with a rash in paeditrics

PaedShots

Fever with a rash ( 1ST PART) Enjoy the videos and music that you love, upload original content and share it all with friends, family and the world on YouTube.

Fever with a rash

# fever # red spots

Images in neonatal medicine...

A preterm female neonate born at 34 weeks’ gestation with Noonan syndrome caused by a de novo pathogenic PTPN11 variant1 and ductus venosus agenesis presented with severe generalised oedema, bilateral chylothorax and prominent caput medusae.

Postnatally, immediate intubation was required for respiratory insufficiency, followed by bilateral chest drains for severe pleural effusions. Magnetic resonance angiography demonstrated diffuse subcutaneous and intrapulmonary lymphangiectasia, consistent with a generalised venolymphatic malformation.

How would you manage this neonate?

Find out more here: https://bit.ly/3PHzezh

Oxygen effect on premature babies Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

https://youtu.be/IfgSlOV16l8?si=qC23a5fnHd3uOHfc

Retinopathy of Prematurity
How and when ?

Oxygen effect on premature babies Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

White lung appearance in lung ultrasound with small areas of subpleural consolidation
Types of lines in lung ultrasound in neonates
A ,B ,C , E and Z lines