Stola Anita, Perlman Jeffrey
Weill Cornell Medical College, New York 10021, USA.
Semin Fetal Neonatal Med. 2008 Dec;13(6):424-31. doi: 10.1016/j.siny.2008.04.011. Epub 2008 May 23.
The interruption of placental blood flow during labor with redistribution of cardiac output resulting in increased flow to brain, heart, and adrenal glands at the expense of flow to kidney, gut, and skin can result in systemic organ as well as cerebral injury. Thus, post-resuscitation strategies should focus on both the management of potential systemic organ dysfunction and on methods of preventing ongoing brain injury in high-risk infants. General management strategies should include ventilator management to maintain pCO(2) values in the normal range, close attention to blood pressure to avoid hypotension, striving to avoid hypoglycemia, and control of seizures. Modest hypothermia administered within the first 6 hours has been shown to reduce neurodevelopmental deficits and death in those infants at highest-risk infants for developing hypoxic-ischemic brain injury.
分娩期间胎盘血流中断，心输出量重新分布，导致流向脑、心脏和肾上腺的血流增加，而流向肾脏、肠道和皮肤的血流减少，这可能会导致全身器官以及脑损伤。因此，复苏后的策略应既注重潜在全身器官功能障碍的管理，也注重预防高危婴儿持续脑损伤的方法。一般管理策略应包括呼吸机管理以维持pCO₂值在正常范围内，密切关注血压以避免低血压，努力避免低血糖，以及控制惊厥。在出生后6小时内给予适度低温已被证明可减少发生缺氧缺血性脑损伤风险最高的婴儿的神经发育缺陷和死亡。
