Ebook Care of the newborn - A handbook for primary care: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Care of the newborn - A handbook for primary care: Part 2
Ebook Care of the newborn - A handbook for primary care: Part 2
11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2of ill newborns. This chapter addresses oxygen physiology, the risks and benefits of oxygen therapy, blood gas analysis, oxygen delivery systems, blood sampling techniques, and noninvasivc blood gas monitoring.Oxygen physiology. The amount of oxygen available to body tissues depends, in part, on the Ebook Care of the newborn - A handbook for primary care: Part 2 environmental oxygen concentration, the amount, of oxygen in the airways, and, ultimately, the amount of oxygen in the blood. l'io2 refers to the fraEbook Care of the newborn - A handbook for primary care: Part 2
ction of oxygen in inspired air and is expressed as a percentage, for example. 21%, or in decimal form, for example, 0.21. PaC)2, measured in mm Hg, i11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2in the arterial blood. Oxygen is transported in blood either freely dissolved or bound to hemoglobin (lib) within the red blood cell. The oxyhemoglobin saturation (Saib) is the percentage of lib that is carrying oxygen.The amount of oxygen available to the tissues is determined not only by the amoun Ebook Care of the newborn - A handbook for primary care: Part 2t of oxygen in the blood, that, is, oxygen content., but. also by how effectively the oxygen is supplied lo the tissues, that is, oxygon delivery. BotEbook Care of the newborn - A handbook for primary care: Part 2
h oxygen content, and oxygen delivery and the factors that influence them arc defined in the following paragraphs.The total oxygen content of the bloo11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2nt, the simplified equation for oxygen content, of the blood is:02 content - 1.34 X lib X SaOj>By increasing the oxygen saturation, for example, from 80% to 100% at a constant lib level, the oxygen content will increase by approximately 25%. In most instances, the oxygen saturation can be elevated b Ebook Care of the newborn - A handbook for primary care: Part 2y increasing the amount of supplemental oxygen the infant, receives. Alternat ively, increasing the amount of Hl), as occurs with a blood transfusion,Ebook Care of the newborn - A handbook for primary care: Part 2
may also significantly increase the oxygen content, of the blood.The relationship between Pao2 and the amount of oxygen bound to lib can be seen from11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2However, small increases in the Pa<»2 in the sleep part of the curve will result in a significant, increase ill oxygen saturation and, therefore, a significant, increase in the total oxygen content, of the blood. Tn contrast. there are a number of factors that decrease the amount of oxygen that lib Ebook Care of the newborn - A handbook for primary care: Part 2will bind, with subsequent shift of the oxyhemoglobin curve to the right. These factors include acidosis. hypothermia, increased partial pressure of cEbook Care of the newborn - A handbook for primary care: Part 2
arbon dioxide (Paco^, an increase in 2,3-diphosphoglycerate (2,3-DPG), and adult Hb. Minimizing these factors will improve oxygen saturations.Hypoxia,11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2quirement beyond the ability of the infant to meet those demands. Oxygen delivery to the tissues is dependent on four factors: (1) adequate alveolar ventilation: (2) adequate gas diffusion between the alveoli and the blood; (3) sufficient, concentration of Hb; and (4) adequate cardiac output to ensu Ebook Care of the newborn - A handbook for primary care: Part 2re homeostatic transport of oxygen to the tissues. The first three are important determinants of the oxygen content of the blood. For oxygen to reachEbook Care of the newborn - A handbook for primary care: Part 2
the periphery so that it can be utilized, there needs to be adequate cardiac output. The cardiac output is dependent upon the stroke volume of the hea11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2horax, congenital complete heart block, or obstruction to ventricular output as may occur inCh. 11 Oxygen: Use and Monitoring 109Figure 11-1. Oxyhemoglobin dissociation curves for fetal and adult hemoglobin (Hb).congenital heart disease), cardiac output may be diminished. This will result in a decre Ebook Care of the newborn - A handbook for primary care: Part 2ase in delivery of oxygen, even though oxygen may be present in the blood in high concentration.Oxygen delivery to the tissues is thus dependent on boEbook Care of the newborn - A handbook for primary care: Part 2
th the content of oxygen in the blood and the cardiac output, lienee:oxygen delivery — cardiac output X Oxygen contentSome of the more common clinical11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2sion (Q) within the lung. Oxygen must, be effectively delivered to the alveolar unit and then be picked up by the cừculating blood. V/Q mismatch may result from intrapul-monary shunting of blood caused when capillary blood perfuses collapsed alveoli and no gas exchange occurs. Alternatively, the lun Ebook Care of the newborn - A handbook for primary care: Part 2gs may ventilate well but there is a perfusion defect. This may occur with right-to-left shunting of blood through a septal defect in the heart or theEbook Care of the newborn - A handbook for primary care: Part 2
presence of a ductus Arteriosus. This shunted blood subsequently does not come into contact with alveoli, and therefore docs not. pick up oxygen.III.11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2t to eliminate central cyanosis. Whenever there is a question concerning the amount of oxygen required, one should err on the side of too much rather than too little oxygen until further objective assessments can be made.The 2002 Guidelines for Perinatal Care* a joint publication of the American Aca Ebook Care of the newborn - A handbook for primary care: Part 2demy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology' (ACOG), makes the following recommendations regarding the use of oxygeEbook Care of the newborn - A handbook for primary care: Part 2
n in newborns:•Supplemental oxygen should not be used without a specific indication, such as cyanosis, low Pao2, or low oxygen saturation.•The use of 11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2ygen therapy should be administered in nurseries unequipped to monitor Pao2 or oxygen saturation, before consideration of transfer to a higher level unit, is contingent on the gestational age of the neonate and the severity of oxygen deficit. In general, neonates delivered at less than 36 weeks gest Ebook Care of the newborn - A handbook for primary care: Part 2ation or those requiring more than 40% ambient oxygen should be stabilized and transferred promptly.•For neonates who require oxygen for acute care, mEbook Care of the newborn - A handbook for primary care: Part 2
easurements of blood pressure, blood pH. and PaCOa should accompany measurements of Pao2. In addition, a record of blood gas measurements, details of 11Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care o Ebook Care of the newborn - A handbook for primary care: Part 2Handbook for Primary CareTable 11-1. Conditions that affect oxygen deliveryAmount of oxygen in bloodHemoglobin concentrationPartial pressure of oxygen (Pao2)Oxygen-hemoglobin affinityDelivery of oxygenCardiac outputBlood pressure Ebook Care of the newborn - A handbook for primary care: Part 211Oxygen: Use and MonitoringMatthew E. Abrams and Neal SimonDescription of the issue. Oxygen is an important and frequently used therapy in the care oGọi ngay
Chat zalo
Facebook