新生儿硬肿症宣讲培训.pptVIP

Neonatal Cold Injury Syndrome (sclerema neonatorum); Objectives; Definition -- mainly caused by cold stress --the clinical features are low body temperature and scleredema --serious one may appear multiple organ dysfunction. ; Etiology and pathophysiology Characteristics of temperature regulation and subcutaneous fatty composition in newborn ● immaturity of temperature regulation center ● relative large surface area and rich blood flow cause poor thermal insulation;● limited storage of energy, heat production mainly by brown fatty metabolism, lacking shivery thermogenesis ● more quantity of saturated fatty acid with higher melting point Imbalance between heat production and loss; ;Imbalance between heat production and loss;Imbalance between heat production and loss;immature of temperature center relative larger surface ;Anoxia, acidosis;;● feature: skin and subcutaneous tissue become indurated, woody, non-pitting, cold to touch, involved area may with edema, redness, cyanosis; symmetrical ● Sequence: calves→thighs→low extremities→buttock→cheeks→upper extremities→whole body;Neonatal scleredema; multiple organ dysfunction ● bradycardia, dyspnea, ● microcirculation disturbance, ● shock, DIC, ● acute renal failure, ● pulmonary hemorrhage;Evaluation of body surface area; Degrees of NCIS Body temperature(℃) involved area change of organic anus T axil – anus T (%、color) function I0 ≥ 35 positive 20 no change (mild) pale II0 35 0 or positive 20～50 poor reaction (moderate) dark red bradycardia III0