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2016, Number 1

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Acta Med 2016; 14 (1)

Early stabilization of the preterm newborn less than 1200 grams

Nuñez PAJR, Orozco GA

Language: Spanish
References: 51
Page: 25-31
PDF size: 159.92 Kb.


ABSTRACT

In newborns weighing less than 1,200 g, the objectives of monitoring and therapeutic intervention are established during the first 24 hours of life, which are: to diagnose low systemic flow and by organs by means of detecting background and clinical data such as perinatal asphyxia, sepsis, bleeding, mechanical ventilation, hypotension, hypoperfusion, metabolic acidosis and renal failure. To obtain adequate ventilatory management reaching goals as pH 7.25-7.40, pCO2 higher than 35 and up to 55 mmHg and PO2 between 30 and 60 mmHg in capillary samples. Maintaining adequate cerebral perfusion by obtaining optimal mean blood pressure (15% above the gestational age in weeks) through measures such as late clamping or arrangement of the umbilical cord and the use of vasoactive drugs if necessary. Monitoring early brain changes by amplitude-integrated electroencephalogram and cerebral Doppler ultrasonography. Monitoring and knowledge of physiological limits of vital signs and the stratification of variations in this period, changes the clinical course by early recognition and management of ventilatory, hemodynamic and perfusion problems.


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