Neonates are prone to respiratory problems for a variety of reasons. Anatomic causes are a barrel-shaped chest, a flattened diaphragm, limitation of diaphragmatic movement by abdominal compression, smaller airway diameter, and higher closing volumes. The high compliance of the chest wall, low compliance of the lungs, and less fatigue-resistant fibers in the diaphragm and intercostal muscles are also significant contributory factors. Cardiorespiratory symptoms are also more common in this age group since structural and functional abnormalities of the airway and heart are more likely to present at this time.
Cardiorespiratory symptoms in neonates are nonspecific and may be due to primary organ failure (cardiovascular or respiratory) or secondary to a variety of systemic diseases, such as sepsis, metabolic acidosis, abdominal pathology, and severe meningitis. Regardless of the cause, the assessment and stabilization of the airway, breathing, and circulation are priorities and should be accomplished before or concurrently with establishing a diagnosis.
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