DEFINIŢIE: lichid HEMORAGIC în trahee / hemoragie masivă cu alterarea stării generale (MASIV ≥ 2 lobi) HEMORAGIA PULMONARĂ FACTORI DE RISC IUGR Prematuri PCA VAP SDR Sepsis BHNN Coagulopatii Asfixie severă SEMNE CLINICE: debut în ziua 2-4 de viaţă tahicardie apnee, DR ↓SaO2 hTA DIAGNOSTIC LABORATOR AGS: hipoxie, hipercarbie, acidoza respiratorie / mixtă HLG: Hb↓,Ht↓ COAGULARE: alterarea factorilor de coagulare IMAGISTIC Pulmon OPAC (în totalitate dacă HP este masivă) MANAGEMENT DE URGENŢĂ IOT-VAP PIP>25,PEEP=6-12,TI=0.4-0.5’’ ASPIRARE sânge pe sonda endotraheală (în caz de obstrucţie!) Adm. ADRENALINA (1/10000)-0.1ml/kgc+0.5ml SF Transfuzie SツNGE/PLASMĂ 10 ml/kgc Dacă există hTA/şoc – VOLUM EXPANDER 10-20 ml/kgc Vit K CTb PPC Corectia ACIDOZEI Autori: Prof. Dr. Maria STAMATIN, Data elaborarii: 2010, dupa „Manual de urgente neonatale”, Chisinau 2009
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DEFINIŢIE: lichid HEMORAGIC în trahee / hemoragie masivă cu alterarea stării generale(MASIV ≥ 2 lobi)
ASPIRARE sânge pe sonda endotraheală (în caz deobstrucţie!)
Adm. ADRENALINA (1/10000)-0.1ml/kgc+0.5ml SF
Transfuzie SÂNGE/PLASMĂ10 ml/kgc
Dacă există hTA/şoc – VOLUM
EXPANDER 10-20 ml/kgc
Vit K CTbPPC
CorectiaACIDOZEI
Autori: Prof. Dr. Maria STAMATIN, Data elaborarii:2010, dupa „Manual de urgente neonatale”, Chisinau 2009
Prescurtari:IUGR – întârziere în creşterea intrauterinăPCA – persistenţa canalului arterialVAP – ventilaţia artificială a pulmonilorSDR – sindrom de detresă respiratorieBHNN – boala hemolitică a nou-născutuluiSaO2 – saturaţia hemoglobinei în oxigenhTA – hipotensiune arterialăAGS – analiza gazelor sanguineHLG – hemoleucogramăPIP – presiune inspiratorie pozitivăPEEP – presiune pozitivă la sfârşitul expiruluiTI – timp inspiratorPPC – plasmă proaspătă congelată
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