«Асфиксия»

Pathogenesis

• Acceleration of satellite mining
• Acceleration of fetal circulation
• Increased erythropoiesis - an increase in the number of erythrocytes, an increase in OTC
• Increased activity of the adrenal glands
• Increased glucocorticoids

Compensator reaction

• Anaerobic glycolysis active
• Horse marcaslanishuvi
• Con tomiralar utkazuvchanligi ortishi

Decompensation stage

Pathomorphological scales

Brain tumor

Hemorrhagic infarction

Leukomalacia

Injured limbs in asphyxia (limbs)

Hypoxic injury of the MNS

Myocardial ischemia, heart failure

NBS. Upka mining

YANEK

Liver dysfunction

Disorders of the hemostasis system

Kidney failure

Polyorgan injuries

CLASSIFICATION

Let's go round

Antenatal

ИнтраIntranatalнатал

Mixed

Depending on the level of weight

medium heavy

Heavy

Breathing

Heartbeat

Terry ranks

Muscle tone

Reflex excitability

Indicators of the APGAR table

Apgar scale

SYMPTOMS	0	1	2
Heartbeat (1 min)	NO	Less than 100	More than 100
BREATHING	NO	Bradipnoe, irregular	A resounding scream
REFLECTOR EXTRAORDINARY	No reaction	grimasa	Cough, sneeze
MUSCLE TONE	The foot slaves are hanging	The foot slaves are slightly bent	Active actions
SKIN COLOR	pale	Central cyanosis	Hungry pink

Evaluation on the Apgar scale

1-3 points - severe asphyxia

4-6 points - moderate asphyxia

7-10 points - indicates the absence of asphyxia

Clinic of moderate to severe asphyxia:

His condition is moderate

Ташки таъсуротларга реакцияси суст

Spontaneous movements

Physiological reflexes are impaired

Skin color cyanotic ("blue asphyxia")

On cardiac auscultation, tachycardia, heart sounds are suffocated

on auscultation of the lungs, faint, wet wheezing is heard

Clinic of severe asphyxia:

The condition is serious or very serious

Low or no muscle tone, spontaneous movements, reaction to external impressions

Physiological reflexes are not summoned in the 1st hour

Skin color blue-white or oozing ("white asphyxia")

Heart sounds muffled, systolic murmur can be heard

Mechanical complications occur when or during labor

Hypoxic shock clinic

Condition is very serious, stuporoz

Brain tumor

Skin color is whitish, flaky

The “white spot” symptom is 3s and more

A / B low or very low

There is no independent breathing

No muscle tone, spontaneous movements, no reaction to external impressions

Eyes closed, reaction to light very slow or absent

Heart sounds muffled, heard only in the epigastric region, rough systolic murmur, dilated heart

Disorders of blood clotting

Evaluation of less than 7 points on the 1st and 5th minute on the Apgar scale

Disorders of vital organs (CNS, respiratory, cardiovascular, urinary and gastrointestinal systems)

Acidosis in the umbilical cord blood (pH <7.2)

Neurological disorders

Diagnostic criteria

Diagnostics

• Anamnestic data (risk factors leading to perinatal hypoxia)
• Antenatal monitoring of the fetus (fetal distress)
• Scores below 7 on the Apgar table
• Neurological disorders
• Laboratory tests

Diagnostics

Infantile asphyxia in the intranatal period. Severe degree.

Injury of the MNS with hypoxic-ischemic genesis. General attenuation syndrome. Acute period.

Clinical diagnosis

early

MNS injury

Lungs

Kidney

Hematological

Dinner

Infections (pneumonia, sepsis, NEK)

IUGR

Neurological (paresis, paralysis)

oligrophenia, DSP

convulsions, epilepsy

COMPLICATIONS

BRAIN BRAIN NEUROSONOGRAPHY

Reanimation

А

В

С

D

АФИКСИЯНTREATMENT OF AFFICIENCYИ ДАВОЛАШ

Treatment of asphyxia (resuscitation) Resuscitation is carried out in stages

А

• Airways (ensuring airway patency)

B

• Вreathing (restore breathing)

С

• Сirculation (recovery of heart function)

D

• Drug (delivery of drugs)

Preparation for resuscitation

Room preparation:

The room should be well lit.

Room temperature should not be below 25 ° C

Absence of skvoznyaks

Have warm, dry towels and diapers

The clock has a second hand

There is a resuscitation table or other flat area with a heater

Sterile gloves

Sterile, umbilical cord cutting devices

Necessary processing of staff slaves

Required tools and equipment:

Devices for pulmonary ventilation: Ambu bag and masks of 2 different sizes (№0 and №1)

Devices for cleaning the airways: pear, catheter

Medications: adrenaline, saline

Sterile syringes

Tools for intubation: laryngoscope, tweezers, intubation tubes, transducer, conductor

Oxygen

Instructions for resuscitation

• He can't breathe
• He stops and breathes
• Shortness of breath
• Muscle hypotonia

The child's condition:

• Cutting the umbilical cord
• Take the child to the hot resuscitation table
• Dry the baby
• Proper bedding
• Clean the airways

Immediately do the following:

• Heat supply
• Proper bed rest, clearing the airways of mucus (if necessary)
• fertilization, stimulation, re-placement of the child

• Starting ventilation is under negative pressure

Heart rate <60

Apnea or ChSS <100

• Provide effective ventilation
• Initiation of indirect cardiac massage

• Is it on time?
• Is Kogonok water clean?
• Breathing or screaming?
• Is the muscle tone good?

• Evaluation of respiration, heart rate, skin color

Standard maintenance

Heat supply

Child bullying

Clean the airways of mucus (if necessary)

Evaluate skin color

Yes

BIRTH

Heart rate <60

• Sending adrenaline

Understanding the need for intubation

Give oxygen if cyanosis is persistent

30 sec

30 sec

А

В

С

D

30 sec

No.

Resuscitation Algorithm

European Resuscitation Council, 2005

30 sec

Phase A is to ensure airway permeability.

The baby's mouth and nose are cleaned of mucus using a rubber balloon. Tactile stimulation is performed

Stage V - Restoration of respiration

Амбу копчаси ёрдамида сунъий нафас берилади. Болани чалканча ёткизиб, боши бироз оркага кайрилади. Елкаларнинг остига валик куйилади («аксириш позаси»). Масканинг размери танланади, чакалокнинг

юзига урнатиб сунArtificial respiration is given using an ambulance bag. Lay the child on his back and turn his head slightly back. A roller is poured under the shoulders ("sneeze pose"). The size of the mask is chosen, the baby

artificial respiration is given by setting it on the face (counted in waltz rhythm). 40-60 breaths in 30 seconds.ъий нафас берилади (вальс ритмида санаб). 30сонияда 40-60 та нафас.

mask selection

WHO,1997

© AAP/AHA 2000

S - stage Restoration of cardiac activity

The child's dagger-shaped tumor is crushed by 2-3 cm by burning the fingers 1 cm above the point of attachment to the sternum.

(listed in marsh rhythm), in a 1: 3 ratio with exhalation

Indirect cardiac massage technique

A

B

A is the thumb technique

B is a two-finger technique

European Resuscitation Council , 2005

Stage D - delivery of drugs to the umbilical vein:

1. 0.1-0.3 ml / kg of adrenaline dissolved in a ratio of 1: 10000

2. Saline solution 10 ml / kg (in order to restore OTC)

References

Basic literature

1. A.V.Alimov. Neonatology, Tashkent, 2012. 2. N.P.Shabalov. Neonatology, St. Petersburg, 2004. 3. The basis of a healthy and sick newborn child. Kamilov A.I., Tashkent. 2007 4. Reshenie problem novorojdennyx. Guidance for effective practice. WHO 2005.

Additional literature 5. Resuscitation of infants. Tashkent. 2014.

6.Effektivnaya perinatalnaya pomoshch i uxod (EPU)

7. Breastfeeding. D.I.Makhmudova, M.N.Akhmedov, A.L.Tolipova and others. Tashkent, M.Meditsina, 2003

8. Intrauterine infections in newborns.Z.J.Raxmankulova, Z.S.Kamalov, T.U.Aripova Tashkent, 2016

9. Neonatology Natsionalnoe rukovodstvo, N.N.Volodin, E.N.Baybarin, G.N.Buslaeva, D.N.Degtyarev. 2008.Moscow

10. Head of the district pediatrician T.G.Avdeeva, 2008, Moscow

11 Teplovaya zashchita novorojdennogo.Prakticheskoe rukovodstvo (Bezopasnoe materinstvo), UNICEF. Tashkent, 2009

12. Neonatology. Practical recommendations R.Rooz, O.Gentsel-Borovicheni, G.Prokitte.Moskva. Medical literature, 2011

13. Normative documents: Orders № 500,80,81,88,378,600, 226,176,74,480

Websites 14.http:

Thank you for your attention