The physiology of neonatal resuscitation

被引:26
|
作者
Hooper, Stuart B. [1 ,2 ]
Kitchen, Marcus J. [3 ]
Polglase, Graeme R. [1 ,2 ]
Roehr, Charles C. [4 ]
te Pas, Arjan B. [5 ]
机构
[1] Monash Univ, Hudson Inst Med Res, Ritchie Ctr, Melbourne, Vic, Australia
[2] Monash Univ, Dept Obstet & Gynaecol, Melbourne, Vic, Australia
[3] Monash Univ, Sch Phys & Astron, Melbourne, Vic, Australia
[4] Univ Oxford, Dept Paediat & Neonatol, Oxford, England
[5] Leiden Univ, Med Ctr, Dept Pediat, Div Neonatol, Leiden, Netherlands
基金
澳大利亚国家健康与医学研究理事会;
关键词
airway liquid clearance; birth; preterm birth; respiratory function; transient tachynopea of the newborn; FUNCTIONAL RESIDUAL CAPACITY; LUNG LIQUID CLEARANCE; SUSTAINED INFLATION; PRETERM INFANTS; RESPIRATORY TRANSITION; NEWBORN; BIRTH; AERATION; PRESSURE; GROWTH;
D O I
10.1097/MOP.0000000000000590
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose of reviewAs the infant's physiology changes dramatically after birth, modern neonatal resuscitation approaches should detect and be modified in response to these changes. This review describes the changes in respiratory physiology at birth and highlights approaches that can assist these changes.Recent findingsTo better target assistance given to infants at birth, the changes in lung physiology have been classified into three phases. The first phase involves lung aeration. As little or no gas exchange can occur, assistance should focus on airway liquid clearance. During the second phase, as airway liquid resides in lung tissue, assistance should focus on minimizing the complications associated with lung edema. The third phase occurs whenever the liquid is cleared from the tissue and respiratory mechanics stabilize. Although more traditional approaches are most effective during this phase, this is not the case for the first two phases. Furthermore, the glottis actively adducts during apnea in newborns and so noninvasive respiratory support requires the infant to be breathing so that the glottis will open.SummaryThe respiratory support provided to infants at birth should match the infant's changing physiology during transition, which requires a more sophisticated approach and equipment than current recommendations.
引用
收藏
页码:187 / 191
页数:5
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