Examination, Therapeutics, and Monitoring of the Respiratory System: Section I: Physical Examination

Physical examination begins outside the stall and involves determination of the respiratory rate at rest and evaluation of the general attitude, demeanor, movement, and spontaneous activity of the neonate. The respiratory rate, pattern, and effort are readily determined by observation in the neonate. Thoracic palpation and observation for symmetry is the next step of the examination, with the thoracic cage closely evaluated for abnormal swelling or rib profiles, which is suggestive of thoracic trauma. Production of fetal lung fluid plays a critical role in fetal lung development and maturation. Clearance of this fluid from the airways and interstitium at birth is essential for normal ventilation and gas exchange in the newborn. Radiographic patterns may aid in characterization of respiratory disease but can also correlate poorly with clinical severity or lag behind progression or response to treatment. Respiratory support through mechanical ventilation is an important therapeutic modality in treating septic shock.