Neonatal Resüsitasyona Güncel Yaklaşım
Synopsis
This study details current approaches to neonatal resuscitation applied to newborns transitioning from the intrauterine environment to extrauterine life. The primary objective in infants requiring respiratory and circulatory support after birth is to ensure lung ventilation and perfusion, with an increase in heart rate recognized as the most valuable indicator of response to resuscitation. While skin-to-skin contact with the mother, proper cord management, and thermal protection facilitate transition in healthy infants, delaying cord clamping for at least one minute is recommended in newborns who do not require resuscitation. Routine oro-nasopharyngeal aspiration should be avoided and performed only prior to positive pressure ventilation (PPV) or in cases of significant airway obstruction. In PPV applications, ventilation efficacy is primarily monitored by heart rate improvement. The two-thumb technique, which provides higher systolic and coronary perfusion pressure, should be the primary choice in chest compressions. In case of inadequate response, intravenous adrenaline (0.01–0.03 mg/kg) should be administered, and volume expanders such as 0.9% NaCl (10 ml/kg) should be considered if there is a history of blood loss or unresponsiveness. Since secondary apnea does not respond to tactile stimulation, ventilation must be initiated without delay, and oxygen therapy should be managed via pulse oximetry monitoring. Preventing hypothermia is a fundamental cornerstone, especially in premature infants. Successfully resuscitated infants must undergo specialized monitoring in a neonatal intensive care unit, whereas resuscitation should be discontinued if no heartbeat is detected for 10 minutes.
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