医药卫生新生儿窒息复苏教程第1课ppt课件.pptVIP

第一课:复苏过程中相关的危险因素 产前因素 产时因素 ? 2000 AAP/AHA 第一课: 为什么早产儿更危险? ? 2000 AAP/AHA 早产儿肺部缺乏肺泡表面活性物质，可能会导致呼吸困难。 脑发育不完善，可能会减少对呼吸的驱动。* 肌肉张力低，可能会使自主呼吸更困难。* 表皮薄、体表面积大和皮下脂肪少，所以散失热量多。 出生时极易受到感染。 大脑血管非常脆弱，缺氧可能导致出血。 血容量少，更容易受到失血所致低血容量的危险。* 不成熟的组织更容易受到过度氧气的损害。* 第一课: 复苏后护理 ? 2000 AAP/AHA 去除肤色红润？ 增加吸氧流程 观察护理 复苏后护理 常规护理 近90%的新生儿是无危险因素、羊水清、有活力的足月儿。出生后，他们无需与母亲分离，接受复苏的最初步骤。必要时擦干婴儿的口和鼻以清洁上呼吸道。 观察护理 有产前或产时危险因素，羊水或皮肤粪染，呼吸或活动抑制，和/或皮肤紫绀的婴儿将需要密切的评价。在许多情况下，需要转入具有心肺功能监护和生命体征监测的新生儿室。 复苏后护理 应用正压人工呼吸或更多措施复苏的新生儿需要继续给予支持，他们有再次恶化的可能，处于因异常过渡而发生并发症的高度危险之中。可能有必要转到新生儿重症监护病房。 第一课: 复苏后护理 Cardiopulmonary Transition in the High Altitude Infant Arterial oxygen saturation in quietly sleeping infants falls with higher altitude. SUSAN NIERMEYER, HIGH ALTITUDE MEDICINE BIOLOGY , Volume 4, Number 2, 2003 Cardiopulmonary Transition in the High Altitude Infant SUSAN NIERMEYER, HIGH ALTITUDE MEDICINE BIOLOGY , Volume 4, Number 2, 2003 Cardiopulmonary Transition in the High Altitude Infant The breathing pattern was deeper and slower at high altitude, and oxygen extraction was signficantly greater in the high altitude group (Mortola et al., 1992). SUSAN NIERMEYER, HIGH ALTITUDE MEDICINE BIOLOGY , Volume 4, Number 2, 2003 Cardiopulmonary Transition in the High Altitude Infant Twenty infants in Lima (50m) and 20 infants in Cerro de Pasco, Peru (4330m), were studied at environmental temperatures of 35° and 26°C. Under both conditions, infants at high altitude had slight, but significantly lower body and skin temperatures than their low altitude counterparts. At low altitude, cooling increased oxygen consumption by approximately 34%, but no significant increase occurred in the high altitude group (Frappell et al., 1998). SUSAN NIERMEYER, HIGH ALTITUDE MEDICINE BIOLOGY , Volume 4, Number 2, 2003 Cardiopulmonary Transition in the High Altitude Infant Perinatal hypoxia in experimental animals alters pulmonary development at the level of the gas exchange unit. At higher altitudes, several lin