Abstract

MORAES, MARIO et al. Atención neonatal del recién nacido deprimido severo de término. Arch. Pediatr. Urug. [online]. 2005, vol.76, n.3, pp.202-209. ISSN 1688-1249.

Summary Introduction: perinatal asphyxia translates gas exchange decrease characterized by hypoxia, respiratory alkalosis and metabolic acidosis. It can start during labor and continue afterwards. Knowing that these factors may be more aggressive after resuscitation, is an important aspect for the neonates´management. Objective: knowing the results from the treatment given to severely deprived term neonates in the ICU in order to create. Materials and methods: a retrospective study from neonates who were at the ICU in a one-year period was done. Creating guidelines according to the neonatologists convoked by the Uruguayan Perinatology Association. Results: a total of 26 medical records were analyzed. The mortality rate was 7,6% (2/26). The hospital stay at the ICU was 12 days (SD 9 days). Umbilical arterial blood gas analysis was not realized in 15% at birth and in 27% one hour later. All patients received oxygen during the procedures. Respiratory assistance was realized during 66 hours (6-144). 6 out of 18 patients (33%) had the level of PCO₂ below 35 mmHg, 2 out of 18 (11%) were over 60 mmHg one hour after birth. 8 of 18 had over 100 mmHg. 4 out of 26 (15%) had blood sugar levels below 0,50 mg/dl during the first day. 9 of 26 neonates (34%) had seizures, only 4 were during the first 6 hours. EEG was not realized during the first 72 hours in 12 of 26 patients. The EEG was abnormal in 8 patients. Head ultrasound was done in 23 of 26 patients. 6 had brain swelling, 1 patient had intracranial bleeding. Conclusions: this study shows a high mortality rate in this group of patients. There is a high incidence of blood gas and glucose abnormalities during ventilatory assistance. Seizures without EEG done were detected. The creation of these guidelines may improve assistance and decrease mortality rate and costs

Keywords : ASPHYXIA NEONATORUM;   INFANT, NEWBORN.

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