RESUMO
Background: Previously mechanical ventilation was primary modality of treatment in preterm neonates with respiratory distress. With the introduction of continuous positive airway pressure (CPAP), the need of mechanical ventilation is reduced. The present study was done to know the therapeutic effects of CPAP as compared to mechanical ventilation in preterm neonates with respiratory distress. To study the duration of oxygen requirement and duration of hospitalisation in preterm neonates treated with CPAP compared to invasive mechanical ventilationMethods: Hospital based prospective study was conducted from November 2013 to November 2014 in Dr. B. R. Ambedkar medical college, Bangalore. All the preterm babies admitted in neonatal intensive care unit with respiratory distress requiring CPAP or mechanical ventilation during study period were included. Total 50 cases were included, out of which 20 (40%) were on CPAP treatment and 30 (60%) were on mechanical ventilation. Outcome was assessed by reduction of respiratory distress with SpO2 more than 88% with FiO2 of 21%.Results: Out of 50 preterm neonates studied, 20 (40%) were on CPAP treatment and 30 (60%) were on mechanical ventilation. Mean duration of oxygen treatment was less in neonates on CPAP (4.8'0.9 days) compared to mechanical ventilated neonates (7.12'0.8days) and it is statistically significant (p value<0.05). Mean duration of hospitalisation was less in neonates on CPAP (19.3'0.76 days) compared to mechanical ventilated neonates (21'1.2 days) but it was statistically not significant (P value >0.05).Conclusions: CPAP as a mode of treatment for preterm babies with respiratory distress reduces the duration of oxygen dependency compared to invasive mechanical ventilation. Difference in duration of hospital stay was statistically not significant in these neonates treated with CPAP and mechanical ventilation.
RESUMO
Las personas con ventrículo único, enfrentan diversas limitaciones que requieren cuidados especializados de Enfermería; esta patología se caracteriza por la presencia de una sola cámara ventricular lo que conlleva a un cortocircuito de la circulación sanguínea de derecha a izquierda a nivel cardiaco, con la consiguiente hipoxemia. Ante estos casos, se exige una particular competencia profesional para otorgar cuidados de calidad, cualquier intervención de Enfermería se rige por criterios éticos que pueden resumirse en trabajar con sentido de responsabilidad y lealtad hacia el paciente, familia y comunidad. El propósito de este artículo es dar a conocer el Proceso de Atención de Enfermería a una adolescente con alteración en la necesidad de Oxigenación, basado en el modelo teórico de las 14 necesidades de Virginia Henderson; en la valoración se utilizó un instrumento especifico, se identificó la necesidad de oxigenación, como la de mayor dependencia, de los datos obtenidos se formularon 2 diagnósticos, para los cuales se planearon intervenciones y cuidados específicos, y se evaluaron consecutivamente a su ejecución los resultados obtenidos, la persona no presentó datos de descompensación hemodinámica, sin embargo debido a la complejidad de la patología no fue posible disminuir el nivel de dependencia.
Persons with a single ventricle face several limitations and require specialized nursing care. This problem is characterized by a right left cardiac blood flux shortcut which leads to hypoxia. In these cases, a special professional competence is required in order to provide quality of care. Any nursing intervention should be ethically oriented towards the patient, family, and community. The objective of this article is to show the Nursing Assisting Process in a teenager with oxygen-needs alterations. The theoretical model was based on the 14 needs proposed by Virginia Henderson. A specific instrument was used. From the obtained data, two major diagnoses were established, and specific care interventions were planned and assessed. The patient did not show major signs of hemodynamic unbalances however, due to the complexity of the pathology, it was not possible to reduce the patient's level of oxygen dependence.
Assuntos
Humanos , Feminino , CriançaRESUMO
PURPOSE: To compare the incidence and clinical characteristics of infants with atypical CLD and those with classic BPD among premature infants less than 32 weeks' gestation. METHODS: Clinical data was collected retrospectively from the 256 premature infants less than 32 weeks' gestation and their mothers during 3-year study period. RESULTS: Among 212 preterm infants less than 32 weeks' gestation who survived to 28 days of life, 19 (9%) had atypical CLD and 38 (17.9%) had classic BPD. Atypical CLD infants were significantly heavier and more mature than classic BPD infants (mean birth weights, 1,100+/-294 g vs 915+/-225 g; and mean gestational age, 26.9+/-1.6 weeks vs 21.1+/-1.3 weeks). Duration of ventilator therapy and oxygen inhalation within 28 days of age were shorter in atypical CLD infants than in classic BPD infants (mean duration of ventilator therapy, 16.3+/-6.9 days vs 27+/-6.8 days; and mean duration of oxygen inhalation, 25.5+/-13.5 days vs 53.8+/-39 days). Oxygen dependency in atypical CLD infants showed bimodal pattern, decreasing gradually to 3-week after birth and upturning to peak at about 5-week after birth. Comparing the respiratory indices between classic BPD and aypical CLD, FiO2 at day 2,7, and 10, and oxygen index at day 2, and 10 were significant in classic BPD, but MAP were not. Considering the birth weight, MAP per birth weight, and modified oxygen index showed more apparent differencies between the two groups. CONCLUSION: 35.5% of total CLD were atypical CLD and showed bimodal pattern in oxygen dependency. Atypical CLD infants were significantly heavier and more mature than classic BPD infants.