ʻAno o ka wā makamua

ʻO ka Apne ke ʻano "ʻaʻohe hanu" a kuhikuhi i ka hanu e lohi a kū paha mai nā kumu āpau. ʻO Apne o ka prematurity e pili ana i ka hoʻomaha ʻana o ka hanu i nā pēpē i hānau ʻia ma mua o 37 mau pule o ka hāpai ʻana (hānau hānau mua).

ʻO ka hapa nui o nā pēpē prematur kekahi kekelē o ka apnea no ka mea ʻo ka wahi o ka lolo e kaohi ana i ka hanu e ulu mau nei.

Nui a hewahewa nā kumu no ke aha i loaʻa ai i nā keiki hānau hou, i ka poʻe i hānau mua ʻia, he apnea, me:

• ʻO nā wahi o ka lolo a me nā ala nerve e kaohi ana i ka hanu e ulu mau nei.
• ʻO nā mākala e hāmama ana i ke ala ākea he ʻoi aku ka liʻiliʻi a ʻaʻole ikaika e like me ka hope o ke ola.

ʻO nā mea kaumaha ʻē aʻe i kahi pēpē maʻi a hoʻomaʻemaʻe paha e hoʻomāhuahua i ka pīpī, me

• Anemia
• Nā pilikia hānai
• Nā pilikia puʻuwai a i ʻole māmā
• Maʻi kīnā
• Nā pae oxygen haʻahaʻa
• Nā pilikia kūmahana

ʻAʻole maʻamau ka hanu ʻana o nā keiki hānau hou a kapa ʻia paha he "hanu manawa." ʻOi aku paha kēia kumu i nā keiki hānau hou i hānau mua ʻia (preemies). Loaʻa iā ia nā ʻāpana pōkole (ma kahi o 3 kekona) o ka hanu pāpaʻu a i ʻole kū ka hanu ʻana (apnea). Hoʻopili ʻia kēia mau ʻāpana e nā manawa o ka hanu mau ʻana he 10 a 18 kekona.

Manaʻo ʻia ka hanu maʻamau i nā pēpē liʻiliʻi. Akā ʻo ke kumu o ka hanu ʻana a me nā makahiki o ka pēpē he mea nui ia i ka hoʻoholo ʻana i ka maʻi o ka pēpē.

ʻO nā māhele Apne a i ʻole nā ​​"hanana" i ʻoi aku ka lōʻihi ma mua o 20 kekona i manaʻo ʻia he koʻikoʻi. He pēpē paha kā ka pēpē:

• Kulu i ka helu o ka puʻuwai. Kapa ʻia kēia kulu helu puʻuwai bradycardia (i kapa ʻia ʻo "brady").
• E hoʻokuʻu i ka pae oxygen (saturation oxygen). Kapa ʻia kēia he desaturation (kapa ʻia kekahi "desat").

ʻAe ʻia nā pēpē āpau ma lalo o 35 mau pule i nā keʻena mālama maʻi hānau hou, a i ʻole nā ​​kahu mālama kūikawā, me nā mea nānā kūikawā no ka mea ʻoi aku ka nui o ka pilikia no ka apnea. ʻO nā pēpē ʻelemakule i ʻike ʻia i loaʻa nā ʻāpana apnea e kau ʻia hoʻi ma nā mākaʻi ma ka haukapila. E hana ʻia nā hoʻokolohua hou inā ʻaʻole preterm a pēpē ke kino.

• Mālama nā mea nānā i ke ana o ka hanu, ka naʻau o ka naʻau, a me nā pae o ka oxygen.
• Hiki i nā kulu i ka helu hanu, ka helu o ka puʻuwai, a i ʻole ka pae oxygen e hoʻokau i nā mea hoʻohoka ma kēia mau mākaʻi.
• ʻO nā pēpē pēpē i kūʻai ʻia aku no ka hoʻohana home ʻaʻole like ia me nā mea i hoʻohana ʻia i ka haukapila.

Hiki i nā haʻalulu no nā kumu ʻē aʻe (e like me ka holo ʻana o ka noho a neʻe paha), no laila ke loiloi pinepine ʻia nā mea nānā e ka hui mālama ola.

Pehea e mālama ʻia ai ka ʻoka ma muli o:

• Ke kumu
• Ehia mau manawa e loaʻa ai
• Ke koʻikoʻi o nā māhele

Nānā maʻalahi ʻia nā pēpē olakino ʻole a loaʻa kekahi mau manawa liʻiliʻi. I kēia mau hihia, hele aku nā ʻāpana ke pā iki ʻia nā pēpē a i ʻole "stimulate" i nā wā ke kū ka hanu.

Hiki ke hāʻawi ʻia i nā pēpē ke olakino, akā ʻo ka poʻe premature loa a me / a i ʻole he nui nā ʻāpana apnea i caffeine. E kōkua kēia i ka hana maʻamau i ko lākou ʻano hanu. I kekahi manawa, e hoʻololi ke kahu hānai i ke kūlana o kahi pēpē, e hoʻohana i ka ʻoki e hoʻoneʻe i ka wai a i ʻole ka mucus mai ka waha a i ʻole ka ihu, a i ʻole hoʻohana i kahi ʻeke a mask e kōkua ai i ka hanu.

Hiki ke kōkua ʻia ke hanu e:

• Kūlana kūpono
• Lohi hānai manawa
• Oxygen
• Kaomi kūmau ala maikaʻi maikaʻi (CPAP)
• Mīkini hanu (ventilator) i nā hihia nui loa

ʻO kekahi mau pēpē e hoʻomau i ka loaʻa ʻana o ka ʻopa akā ua mākua a olakino paha e hoʻokuʻu ʻia ʻia mai ka haukapila ma kahi nānā o ka home apnea, me ka ʻole a me ka ʻole o ka caffeine, a hiki i ka wā i ulu aʻe ai kā lākou ʻano hanu makua ʻole.

ʻO ka ʻAno ka mea maʻamau i nā pēpē wawe. ʻAʻole i loaʻa nā hopena lōʻihi i ka apnea māmā. Eia nō naʻe, ʻoi aku ka maikaʻi o ka pale ʻana i nā ʻāpana he nui a koʻikoʻi paha no ka pēpē ma ka wā lōʻihi.

ʻO ka Apne o ka wā maʻa hele pinepine i ka wā e hoʻokokoke ana ka pēpē i kā lākou "lā palena pau." I kekahi mau hihia, e like me nā pēpē i hānau ʻia ma mua o ka wā a i ʻole he maʻi maʻi māmā, e hoʻomau paha ka apnea i kekahi mau pule.

Apnea - nā keiki hānau hou; AOP; As a me Bs; A / B / D; Kilokilo kik Blue - nā keiki hānau hou; Kilokilo Dusky - nā keiki hānau hou; Spell - nā keiki hānau hou; ʻAno · neonatal

Ahlfeld SK. Nā maʻi maʻi hanu. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KW, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 122.

ʻO Martin RJ. Pathophysiology o ka pālua o ka prematurity. I: Polin RA, Abman SH, Rowitch DH, Benitz WE, Fox WW, eds. ʻO Fetal and Neonatal Physiology. 5th lā. Piladelapia, PA: Elsevier; 2017: chap 157.

ʻO Patrinos ME. Apena Neonatal a me ke kumu o ka kaohi hanu. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 67.