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Resuscitation of Babies Born Preterm

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Title: Mechanical Ventilation in Neonates Author: dr.saluja Last modified by: Guest Created Date: 12/5/2006 11:31:47 AM Document presentation format – PowerPoint PPT presentation

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Title: Resuscitation of Babies Born Preterm


1
Resuscitation of Babies Born Preterm
2
Objectives
  • The risk factors associated with being preterm
  • The additional resource needed for preterm
    delivery
  • Strategies to maintain preterm babys body
    temperature
  • Managing oxygen in premature baby
  • How to assist ventilation in PT baby with
    breathing difficulty
  • Ways to decrease chances of brain injury
  • Special precautions to take after resuscitating
    PT baby

3
Why are Premature Babies at Higher Risk
  • Thin skin, large surface area and decreased body
    fat
  • More heat loss
  • Immature tissues more easily damaged by excessive
    oxygen
  • Weak muscles may make it difficult to breathe
  • Drive to breathe may be less
  • Lungs may be immature and surfactant deficient
  • Immature immune system More likely to get
    infections
  • Fragile capillaries in brain IVH
  • Small blood volume Hypvolemic effects of blood
    loss

4
Additional Resources
  • Additional Trained personnel including someone
    skilled in endotracheal intubation
  • Additional means of maintaining temperature
  • Increase temperature in Delivery room
  • Preheat radiant warmer
  • Reclosable Polythene bag
  • Transport Incubator

5
Additional Resources
  • Oxygen source capable of delivering 21 100
    oxygen
  • Compressed air source
  • Oxygen blender
  • Pulse oximeter

6
How do you Keep the Baby Warm
  • Rare cases of Overheating have been described
    with use of plastic-bag technique

7
How do you Keep the Baby Warm
  • Rare cases of Overheating have been described
    with use of plastic-bag technique

8
How Much Oxygen to use
  • Hyperoxic re-perfusion injury
  • Use Blenders esp if lt 32 weeks
  • Start between 21 and 100. Monitor with
    pulse-oximeter
  • During first few minutes SpO2 of 70-80 may be
    acceptable, as long as HR and SpO2 are increasing
  • If SpO2 are lt 85 and not increasing, increase
    oxygen conc.
  • If HR is not increasing rapidly, take care of
    ventilation and use 100 oxygen

9
How do Assist Ventilation
  • Consider giving CPAP 4 to 6 cm H2O
  • Use the lowest Inflation pressure necessary to
    achieve an adequate response
  • Consider giving Surfactant if baby is
    significantly Preterm lt 30 weeks

10
How do Assist Ventilation
  • CPAP cannot be delivered by self-inflating bag

11
How to Decrease Chances of Brain Injury
  • Handle the baby gently
  • Avoid placing the baby in a head-down position
  • Avoid delivering excessive positive pressure of
    CPAP
  • Pneumothorax or Decreased venous return IVH
  • Use oximeter or blood gases to adjust ventilation
    and oxygen concentration
  • Do not give rapid infusions avoid hypertonic
    solutions

12
Special Precautions after Resuscitation
  • Monitor Blood sugar
  • Monitor for apnea and bradycardia
  • Give an appropriate amount of oxygen and
    ventilation
  • Give feedings slowly and cautiously.
  • Use parenteral nutrition
  • Increase suspicion for infection
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