neonatal neonatal cold injury syndrome referred to as cold injury, caused mainly by exposure to cold, the clinical features are hypothermia and multiple organ damage, serious skin appears hard and swollen, also known at this time neonates. The disease mostly occurs in winter and spring "ielwjefljll",Tiffany Jewelry Sale, cold season. 3 days of birth or premature neonates common. With the performance of the early onset of hypothermia, poor sucking or reject milk, crying and weak symptoms; sicker when hard signs of swelling and multiple organ damage.
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Etiology and pathophysiology of treatment and prevention of clinical etiology and pathophysiology (a) neonatal body temperature regulation and composition of subcutaneous fat characteristics of neonatal body temperature regulation function, and its characteristics are: ① temperature regulation immature central nervous system; ② relatively large skin surface area, blood-rich, easy heat loss; ③ little reserve of energy, lack of heat, especially in preterm children, children with low birth weight and small for ,cheap tiffany jewelry, gestational age children become more evident, with brown fat-based chemical heat production methods, lack of shivering heat production and other physical methods. Therefore, the neonatal period prone to hypothermia. Neonatal subcutaneous adipose tissue fatty acids and more unsaturated fatty acids and more than that, the former high melting point, when exposure to cold or hypothermia caused by various reasons, the sebum prone to hardening, there scleroderma. (B) cold environment or holding cold injury in neonatal improper heat loss can increase heat loss when the heat is insufficient, the body temperature immediately dropped, and then rise to the peripheral small blood vessels, skin, reduced blood flow, cold extremities, and appears slightly circulation disorder, cardiac dysfunction caused by the performance further. Low temperature and low ambient temperatures lead to hypoxia visit, a variety of energy metabolism disorders and metabolic acidosis, severe enough to cause multiple organ damage. (C) other neonatal severe infection (pneumonia, sepsis, purulent meningitis, etc.), premature birth, intracranial hemorrhage and polycythemia psychosis, also prone to temperature regulation and energy metabolism disorders, low body temperature and ,Tiffany Jewellery Outlet, hard swelling appeared. Clinical manifestations (a) low temperature nucleus humidity (the temperature anal 5Cm) often reduced to <35 ℃, severe <30 ℃. Hypothermia early compensatory heat production of brown fat is good, the axillary temperature - rectal temperature values (axillary - rectal temperature) is positive or 0; severe, or longer duration, the energy reserve depletion, the axillary - anal temperature becomes negative . (B) by a hard swelling and edema of the ,Tiffany Jewelry On Sale, formation of hardened sebum, which is characterized by swelling of the skin hard, close to the subcutaneous tissue, can not move, there is edema of mild depression pressure. Hard swelling in order of occurrence are: lateral thigh leg → → → cheek the whole hip leg → → → upper body. Hard swelling can range: 20?? of head and neck; both ,Tiffany Rings, upper limbs 18??; chest and abdomen, 14??; back and lumbosacral 14??; hip 8??; calculated 26?? of lower limbs. (C) multiple organ dysfunction in early heart sound is often low blunt, slow heart rate, microcirculation performance; severe cases can present shock, DIC, acute renal failure and multiple organ failure, pulmonary hemorrhage (MOF) performance. (D) dividing the disease based on clinical manifestations, the condition can be divided into mild, moderate and severe. Treatment (a) Where the rectal temperature rewarming> 30 ℃, and axillary temperature higher than rectal temperature, could be placed preheated to moderate temperatures in the incubator, usually 6 to 12 hours to return to normal body temperature; temperature of less than rectal temperature 30 ℃ higher than is l ~ 2 ℃ warm box until the rectal temperature recovered to 35 ℃, the temperature at the incubator to maintain moderate temperature, constant temperature water bath method can be used such as rapid rewarming measures. Rewarming should be observed in the abdominal wall temperature, rectal temperature, and axillary temperature change at any time adjust the incubator temperature, and also to monitor respiration, heart rate, blood pressure and blood gas. Rewarming basic units available hot water bottle or electric blanket ,Tiffany Accessories, wrapped heated kang and other methods; also can be placed close to infants and a few in the embrace of the human body, relatively safe. (B) the supply of heat and liquid calories should be given intravenously per day 210kJ/kg (daily 50kcal/kg); can into breast milk should be as soon as possible, the heat gradually to day 419 ~ 502kJ/kg (I00 ~ 120 cards / kg). Low temperature structure of glucose injection speed should be steamed bread, usually per minute 6 ~ 8mg/kg; body temperature after the resumption of blood glucose test results according to speed up the infusion rate. Fluid volume can be 0.24ml/kJ (1ml/kcal) calculations. (C) to correct organ dysfunction ① ,Tiffany Bracelet, there microcirculation, shock should be corrected acid, expansion, can be 2:1 liquid 15 ~ 20ml/kg (acidosis was used instead of 14?? sodium bicarbonate solution), in 1 hour by intravenous infusion; following with 1 / 3 or l / 4 张 70 ~ 90ml/kg slow fluid infusion, heart rate may give an early vasoactive drug dopamine, 5 ~ 10μg/kg per minute infusion; ② pulmonary bleeding early endotracheal intubation should be carried out timely processing of positive pressure ventilation in the treatment ③ renal dysfunction and DIC. (D) other based on selection of appropriate antibiotics to prevent infection complications; to other symptomatic treatment. Collaborative nursing diagnosis and health care issues a lack of hypothermia and neonatal thermoregulation. Preterm birth. Infection and other factors. 2, impaired skin integrity and skin sclerosis. Edema, related to poor blood circulation. 3, the risk of infection with skin barrier ,Tiffany Charms, dysfunction related. 4, malnutrition and inadequate intake of less than body requirement related to the potential complications of pulmonary hemorrhage 5. DIC and multiple organ dysfunction caused by cold injury. 6, lack of knowledge of parents of children with warmth and lack of proper parental knowledge. ① Strengthening Prevention neonatal care, maintenance of appropriate maternity ward and neonatal room temperature, not lower than 24 ℃; ③ newborn should be immediately wiped amniotic fluid, to keep warm and wrapped with warm blankets; ③ enhance breast-feeding, supplementary heat ; ④ during neonatal transport should be the appropriate measures to ,Tiffany Cufflinks, protect warming; ⑤ prevention of preterm birth, infection, neonatal asphyxia and other risk factors. Atlas Atlas entry for more extended reading: 1Neonatal cold injury syndrome
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