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DOI :10.5222/j.child.2017.151   IUP :10.5222/j.child.2017.151    Tam Metin (PDF)

Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler

Beril Yaşa, Emine Asuman Çoban, Elmas Zeynep İnce

Yenidoğan bebeklerin sağkalımlarının iyileştirilmesi için annelerine iyi bir antenatal bakım verilirken bebeğe de doğru postnatal yaklaşımda bulunulmalıdır. Doğum odası yönetiminde en önemli zaman “ilk altın dakika” olarak adlandırılan, doğum sonrası ilk bir dakikalık süredir. Bu süre içerisinde bebeğin ısı kontrolü sağlanmalı, hava yolu açıklığı, solunumu ve kalp atım hızı değerlendirilmeli, gereksinim varlığında ilk solunumu başlatılmış olmalı ve satürasyon değerleri nabız oksimetre ile objektif olarak takip edilmelidir. Doğum sonrası zamana göre belirlenen hedef satürasyon değerleri göz önünde bulundurularak fazla ve gereksiz oksijen tedavisinden kaçınılmalıdır. Yapılan son çalışmalar kordon klemplenmesinin en az 30-60 sn geciktirilmesinin bebeklerin daha yüksek hemoglobin değerleri ve demir deposu ile doğduklarını göstermekte, bebeklerin transfüzyon gereksinimlerinin azaldığını bildirmektedir. Solunum desteği gereksinimi olabilecek preterm bebeklerde daha ilk nefesten itibaren sürekli pozitif havayolu basıncı (CPAP) uygulanması bebeklerin entübasyon gereksiniminı ve surfaktan uygulamalarını azaltmaktadır. Preterm bebeklerde profilaktik surfaktan uygulanması günümüzde terk edilmeye başlanmış bir uygulama olup, yalnızca gereksinimi olan preterm bebeklere surfaktan verilmelidir. Günümüzde daha az invazif yöntemlerle surfaktan uygulanması denenmektedir. Canlandırma gereksinimi varlığında gestasyon yaşı 35 hafta ve üzerinde olan bebeklere %21 oksijen ile, gestasyon yaşı 35 hafta altında olan bebeklere ise %21-30 oksijen ile destek başlanmalı, hedef satürasyon değerlerine ulaşana kadar oksijen desteği kontrollü olarak arttırılmalıdır

Anahtar Kelimeler: Term, preterm, yenidoğan, doğum odası bakımı
DOI :10.5222/j.child.2017.151   IUP :10.5222/j.child.2017.151    Tam Metin (PDF)

Novel Approaches in the Delivery Room Care of Term and Preterm Newborns

Beril Yaşa, Emine Asuman Çoban, Elmas Zeynep İnce

While optimal antenatal care is provided for the mother to improve survival of newborn babies, appropriate should be given to the babies. The most important time period in delivery room management is the first minute which is named as “first golden minute”. Within this period, body temperature of the baby should be checked , patency of its airway, its respiratory and heart rate should be assesed, first breath should be initiated in case of need, and saturation must be measured objectively using a pulse oximeter. Excessive and unnecessary use of oxygen should be prevented by considering targeted saturation values which are determined according to the time passed after birth. Recent studies showed that 30-60 seconds delay in umbilical cord clamping time will lead to higher hemoglobin concentrations and iron stores in newborns. Preterm babies who may need ventilatory support should be put on continuous positive airway pressure (CPAP) even from the first breath which will decrease the need for intubation and surfactant administration. Prophylactic administration of surfactant in preterm newborns is being abandoned today, surfactant should only be given to preterm newborns in need. Nowadays, less invasive administration of surfactant (LISA) is being tested. If resuscitation is needed oxygen support should be started with 21% saturated oxygen in newborns at or above 35th gestational age. If the gestational age is less than 35th weeks, 21-30% saturated oxygen should be given at the beginning then, oxygen support should be increased up to targeted saturation levels in a controlled manner.

Anahtar Kelimeler: Term, preterm, newborn, delivery room care

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DIŞA AKTAR



APA

Yaşa, B., Çoban, E.A., & İnce, E.Z. (0001). Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler. Çocuk Dergisi, 17(4), 151-157. https://doi.org/10.5222/j.child.2017.151


AMA

Yaşa B, Çoban E A, İnce E Z. Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler. Çocuk Dergisi. 0001;17(4):151-157. https://doi.org/10.5222/j.child.2017.151


ABNT

Yaşa, B.; Çoban, E.A.; İnce, E.Z. Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler. Çocuk Dergisi, [Publisher Location], v. 17, n. 4, p. 151-157, 0001.


Chicago: Author-Date Style

Yaşa, Beril, and Emine Asuman Çoban and Elmas Zeynep İnce. 0001. “Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler.” Çocuk Dergisi 17, no. 4: 151-157. https://doi.org/10.5222/j.child.2017.151


Chicago: Humanities Style

Yaşa, Beril, and Emine Asuman Çoban and Elmas Zeynep İnce. “Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler.” Çocuk Dergisi 17, no. 4 (Nov. 2024): 151-157. https://doi.org/10.5222/j.child.2017.151


Harvard: Australian Style

Yaşa, B & Çoban, EA & İnce, EZ 0001, 'Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler', Çocuk Dergisi, vol. 17, no. 4, pp. 151-157, viewed 23 Nov. 2024, https://doi.org/10.5222/j.child.2017.151


Harvard: Author-Date Style

Yaşa, B. and Çoban, E.A. and İnce, E.Z. (0001) ‘Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler’, Çocuk Dergisi, 17(4), pp. 151-157. https://doi.org/10.5222/j.child.2017.151 (23 Nov. 2024).


MLA

Yaşa, Beril, and Emine Asuman Çoban and Elmas Zeynep İnce. “Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler.” Çocuk Dergisi, vol. 17, no. 4, 0001, pp. 151-157. [Database Container], https://doi.org/10.5222/j.child.2017.151


Vancouver

Yaşa B, Çoban EA, İnce EZ. Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler. Çocuk Dergisi [Internet]. 23 Nov. 2024 [cited 23 Nov. 2024];17(4):151-157. Available from: https://doi.org/10.5222/j.child.2017.151 doi: 10.5222/j.child.2017.151


ISNAD

Yaşa, Beril - Çoban, EmineAsuman - İnce, ElmasZeynep. “Term ve Preterm Yenidoğanlarda Doğum Odası Bakımında Yenilikler”. Çocuk Dergisi 17/4 (Nov. 2024): 151-157. https://doi.org/10.5222/j.child.2017.151



ZAMAN ÇİZELGESİ


Gönderim07.09.2017
Kabul26.01.2018

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