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Apnea
Apneas represent another important group of respiratory/ventilation dysfunctions in newborns (apart from perinatal asphyxia and respiratory distress syndrome). They are generally defined as a cessation of breathing movements and air flow for more than 20 seconds, thus often being accompanied by desaturation and bradycardia. Spontaneous breathing causes water in lungs to be resorbed into blood and…
Perinatal asphyxia
Perinatal asphyxia = antepartum or intrapartum hypoxia, hypercapnia and acidosis associated with organ dysfunction (predominantly ventilation, circulation and neurologic impairment) Ventilation changes Compensatory tachypnea => primary apnea => gasping => secondary apnea Gasping causes aspiration of amniotic fluid (possibly with meconium) Continued secretion (absence of reversal) through alveolar-capillary membrane => increased amount of fluid…
Oxygen Therapy
We should attempt to maintain normoxemic oxygenation in order to prevent hypoxic injury (mainly in the cerebral tissue). On the other hand, oxygen should be carefully titrated to newborns, especially preterm, due to the negative effects associated with its overuse (reactive oxygen species = ROS). Hyperoxia induces the production of oxygen radicals that subsequently trigger…
Postnatal resuscitation
Perinatal asphyxia remains one of the most common indications for postnatal resuscitation. The necessary prerequisites for successful resuscitation are properly equipped rooms (delivery suite, neonatal wards with the right and functional equipment; warmed up to the temperature of 26 °C) with properly trained personnel. Ventilation (and circulation dysfunction) are indications to initiate resuscitation…
Respiratory distress syndrome
Respiratory distress syndrome (RDS) describes any change to frequency and/or quality of breathing pattern in newborns. Breathing rate < 60/minute (can be up to 70/min during the first hours of life and sets to around 40/min) is considered physiologic and newborn should not display any signs of increased work of breathing…
Prematurity
Preterm birth is defined as any birth before 37 completed weeks of gestation (37+0). It has been estimated to account for up to 11 % of all births. Preterm birth is a substantial cause of neonatal and pediatric morbidity and mortality. Prematurity is the single most important cause of death in the…