0:01

In summary, when reading chest radiographs in a neonate,

0:05

if you're struggling to figure out

0:07

what entity the patient might have, it might be helpful

0:10

to think about this process.

0:13

First, start with the gestational age.

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If you're looking at a baby that is preterm,

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and if they were just born

0:22

or under about a month of age, do they have hazy

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or granular opacities?

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Do they have pleural effusions?

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If yes to both of these,

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you should highly consider neonatal pneumonia.

0:35

If they have hazy opacities, but no pleural effusion.

0:38

Think about surfactant deficiency disease.

0:41

Remember, these two entities can look identical,

0:44

but the presence of a pleural effusion will help point you

0:47

towards neonatal pneumonia.

0:50

Now, do you have a newborn that has bubbly lucencies?

0:54

Then you should think pulmonary interstitial emphysema.

0:57

Again, this is a disorder that can occur as a result

1:00

of baro trauma from mechanical ventilation in a patient less

1:03

than about a month of age.

1:05

However, if you have a patient that was preterm

1:09

but is now over a month of age

1:11

and has bubbly lucencies, think bronchopulmonary dysplasia.

1:16

Now if we go back up the algorithm

1:18

and you have a patient that's term or post-term,

1:21

and if you know that there was meconium staining at delivery

1:26

and or you see on the radiographs rope like opacities

1:30

pleural effusion, or any air leaks such as pneumothorax

1:32

or pneumo mediastinum, think meconium aspiration syndrome.

1:37

However, if you have a term or post-term baby

1:40

and the opacities resolve quickly,

1:42

they're not in respiratory distress.

1:45

Think transient to kidney of the newborn.