physiology

Respiratory discussion , the one you wrote for me

I need to leave responses to 2 peers , 150 words and a citation.

Responses must promote a discussion either by sharing prior knowledge and experiences, making meaningful connections with course content, asking meaningful questions, or challenging viewpoints.

This is due Monday

Student #1

Reply from Sophia

1. Surfactant is a lubricant that is located on and around the lungs. Called pulmonary surfactant, it is synthesized by the alveolar type II cells, as well as being secreted by them (Hamm et al., 1992). Pulmonary surfactant secretion begins at  around 24-28 weeks into the pregnancy and development of the fetus. The fetus will not be able to produce self-sustaining amounts of surfactant until around 32 weeks of pregnancy (Rehman & Bacha, 2022). 

1. The lack of surfactant causes respiratory distress because without the pulmonary surfactant, the lungs will begin to collapse in on themselves. This is because the alveolar sacs will have too much tension, which in turn makes it very hard for the person to breathe. “Insufficient surfactant leads to reduced pulmonary compliance and increased surface tension [
2Links to an external site.,
3Links to an external site.]. This results in increased risk of alveoli collapse at expiration followed by reduction in total surface area for gaseous exchange, as well as the alveolar-capillary diffusion capacity.” (Cheng-Hwa Ma & Ma, 2012). 

1.  A baby who is in respiratory distress due to a sufficient amount of surfactant would suffer from an increased amount of acid in their blood, also known as acidosis. This is because the lungs will decrease in their function of breathing, which in turn can cause the baby to give up on breathing altogether. (
Infant Respiratory Distress Syndrome (Hyaline Membrane Disease) | Boston Children’s Hospital, n.d.).

1. A baby would compensate for the acid-base disorder by over ventilating itself, as this would allow for more oxygen to enter the body. (
Blood Gas Interpretation for Neonates | Safer Care Victoria, 2023)This process can be done with special breathing devices that are small enough for the infant. However, with the over ventilating process, the baby’s  CO2 levels in the blood can potentially drop dangerously low.

References

Hamm, H., Fabel, H., & Bartsch, W. (1992). The surfactant system of the adult lung: physiology and clinical perspectives. 
The Clinical Investigator, 
70(8).

‌Rehman, S., & Bacha, D. (2022). 
Embryology, Pulmonary. PubMed; StatPearls Publishing.

Cheng-Hwa Ma, C., & Ma, S. (2012). The Role of Surfactant in Respiratory Distress Syndrome. 
The Open Respiratory Medicine Journal, 
6(1), 44–53.

‌
Infant Respiratory Distress Syndrome (Hyaline Membrane Disease) | Boston Children’s Hospital. (n.d.). Www.childrenshospital.org. 
to an external site.

Student #2

Reply from Vivi

Surfactant is a mix of fats and proteins that’s released into the tiny air sacs (alveoli) in the lungs. Its main job is to lower the surface tension where air meets the liquid in these sacs. By reducing this tension, surfactant helps keep the alveoli open after exhalation, which is crucial for good breathing and gas exchange. The cells that make surfactant are called type II alveolar cells (Jobe & Ikegami, 2001).

Surfactant starts to be produced around the 24th week of pregnancy, but it only reaches sufficient levels around the 35th week. This timing is why babies born prematurely often have trouble with their breathing, as their lungs might not have made enough surfactant yet (Liggins & Howie, 1972).

Without enough surfactant, the surface tension in the alveoli increases, causing them to collapse. This collapse reduces the area available for oxygen and carbon dioxide exchange, leading to low oxygen levels (hypoxemia) and high carbon dioxide levels (hypercapnia). This condition is known as respiratory distress syndrome (RDS) (Hall & Swaiman, 1984).

High carbon dioxide levels can cause respiratory acidosis, a condition where the blood becomes too acidic. This happens because carbon dioxide combines with water in the body to form an acid, which lowers the blood’s pH (Jobe & Ikegami, 2001).

To try to fix this, the infant’s kidneys work to balance the blood’s acidity by holding onto more bicarbonate and getting rid of excess hydrogen ions. However, this process is slow and might not fully correct severe acidosis (Hall & Swaiman, 1984).

The baby might also breathe rapidly and shallowly (tachypnea) to get rid of excess carbon dioxide and lower the blood’s acidity. But if the surfactant issue isn’t resolved, this can make breathing problems worse (Jobe & Ikegami, 2001).

Treatment for neonatal RDS usually involves giving the baby artificial surfactant and providing other support, like oxygen therapy and mechanical ventilation if needed (Liggins & Howie, 1972).

References:

· Hall, R. T., & Swaiman, K. F. (1984). Respiratory distress syndrome: Clinical and laboratory features. 
Pediatric Clinics of North America, 31(3), 509-523.

· Jobe, A. H., & Ikegami, M. (2001). Surfactant therapy and neonatal respiratory distress syndrome. 
Pediatrics, 108(3), 750-757.

· Liggins, G. C., & Howie, R. N. (1972). A controlled trial of antepartum glucocorticoid treatment for prevention of respiratory distress syndrome in premature infants. 
Pediatrics, 50(4), 515-525.