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[新生儿复苏的基础与新进展]

[Basics and novelties of neonatal resuscitation].

作者信息

Széll András

机构信息

1 Semmelweis Egyetem Budapest Magyarország.

2 Peter Cerny Alapítványi Mentőszolgálat Budapest, Bókay u. 53., 1083 Magyarország.

出版信息

Orv Hetil. 2023 Mar 26;164(12):474-480. doi: 10.1556/650.2023.32733.

Abstract

This recommendation summarizes the recent neonatal resuscitation guidelines of the European Resuscitation Council (ERC), but it takes into account the guidelines of the American Heart Association (AHA) and the statements of the International Liaison Committee on Resuscitation (ILCOR) Consensus on Science with Treatment Recommendations (CoSTR) for neonatal life support. The goal of the management of the newly born infants is to support the cardiorespiratory transition. Personnel and equipment should be prepared for neonatal life support before every delivery. After birth, the heat loss of the newborn must be prevented and, if possible, the clamping of the cord should be delayed. Initially the newborn must be assessed and, if possible, the baby should be kept with the mother in skin-to-skin contact. The infant must be placed under radiant warmer and the airways must be opened, if respiratory or circulatory support is needed. Decisions about the further steps of resuscitation are based on the evaluation of breathing, heart rate and oxygen saturation. If the baby is apnoeic or has a low heart rate, positive pressure ventilation must be started. The effectiveness of the ventilation must be checked, and failures are to be corrected if necessary. If the heart rate is <60/min despite effective ventilation, chest compressions should be started. Rarely, administration of medications is also necessary. After successful resuscitation, post-resuscitation care must be started. In the case of unsuccessful resuscitation, discontinuing management can be considered. Orv Hetil. 2023; 164(12): 474-480.

摘要

本建议总结了欧洲复苏委员会(ERC)最近的新生儿复苏指南,但也参考了美国心脏协会(AHA)的指南以及国际复苏联合委员会(ILCOR)关于新生儿生命支持的科学与治疗建议共识(CoSTR)声明。新生儿管理的目标是支持心肺功能过渡。每次分娩前都应准备好用于新生儿生命支持的人员和设备。出生后,必须防止新生儿体温散失,如有可能,应延迟脐带结扎。最初必须对新生儿进行评估,如有可能,应让婴儿与母亲进行皮肤接触。如果需要呼吸或循环支持,婴儿必须置于辐射保暖台上并开放气道。复苏后续步骤的决策基于对呼吸、心率和血氧饱和度的评估。如果婴儿呼吸暂停或心率低,必须开始正压通气。必须检查通气效果,如有必要应纠正不足之处。如果尽管通气有效但心率仍<60次/分钟,应开始胸外按压。极少数情况下也需要使用药物。复苏成功后,必须开始复苏后护理。如果复苏不成功,可以考虑停止治疗。《匈牙利医学周报》。2023年;164(12):474 - 480。

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