新生儿窒息(英文）演示文稿.pptVIP

新生儿窒息Asphyxia of the Newborn Dr. Xiaoping Luo Professor and Chairman Department of Pediatrics Tongji Hospital Tongji Medical College The highest mortality that befalls the human race in one day occurs on the day of birth. ..…. …… It is said that the most important period of the life of a human being is the time spent in utero. The most trying ordeal a human being sustains is the ordeal of birth. Asphyxia Neonatorum: Causation and Treatment Professor of Obstetrics, Northwestern University Medical School Jos. B. De Lee Published in Medicine (Detroit) 3:643-660, 1897. Definition of Perinatal Asphyxia a condition in the neonate where there is the following combination: An event or condition during the perinatal period that is likely to severely reduce oxygen delivery and lead to acidosis; AND A failure of function of at least two organs consistent with the effects of acute asphyxia. Hypoxemia, Hypercapnia, Mixed acidosis, Organic failure Risk Factors-Maternal Systemic disease: diabetes, heart or renal diseases, anemia, infectious diseases Obstetric Conditions: hypertensive disease of pregnancy or pre-eclampsia, placental abruption Substance abuse: drug addiction, smoking Maternal age: 35, or 16, multiple pregnancy Risk Factors-Fetal Premature, SGA, macrosomia Congenital malformation: nose and laryngo- pharynx malformation, lung hypoplasia, heart disease Amniotic fluid or meconium aspiration Intrauterine infection: Torch syndrome Risk Factors-Intrapartum Umbilical cord: obstruction Obstetric procedures: forceps delivery, breech extraction, vacuum extraction Medication: analgesic and oxytocic medicine Pathophysiology of Asphysia Respiratory Alteration: primary hyperpnea, primary apnea, secondary apnea Hypoxic-ischemic Changes of Multi-organic system: “diving reflex”, inter-organ shunting, organ failure Biochemical and metabolic Consequences: