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Proceso de atención de enfermería aplicado en neonato con síndrome de dificultad respiratoria.
| dc.contributor.advisor | Vargas Angulo, Ligia Elizabeth | |
| dc.contributor.author | Muñoz Diaz, Joselyn Viviana | |
| dc.date.accessioned | 2022-04-26T16:15:54Z | |
| dc.date.available | 2022-04-26T16:15:54Z | |
| dc.date.issued | 2022 | |
| dc.identifier.uri | http://dspace.utb.edu.ec/handle/49000/11300 | |
| dc.description | Respiratory distress syndrome, also called hyaline membrane disease, is the most common pathology in the Neonatal Intensive Care Unit, it occurs in preterm newborns and is the main cause of morbidity and mortality of respiratory origin. Its incidence is reported in 5 to 10% of newborns and this increases significantly at a lower gestational age, with a higher incidence in patients weighing less than 1,200 g and 30 weeks of gestation, this disease is caused by a lack of pulmonary surfactant, a substance that Its main function is to reduce the surface tension forces of the alveoli and maintain the stability and volume of the lungs during expiration. Due to the deficiency of surfactant there is a tendency to alveolar collapse; this produces progressive atelectasis, intrapulmonary circulatory shunt, and hypoxemia. Clinically, it is characterized by progressive early-onset respiratory distress, from birth or in the first 6 hours of life. This respiratory distress is manifested by generally audible grunting, nasal flaring, xiphoid retraction, polypnea, and rapidly increasing FiO2 (fraction of inspired oxygen) requirements. The vesicular murmur is usually diminished, as well as the anteroposterior diameter of the thorax; in severe cases, there is thoracoabdominal dissociation. Edema is often present, and diuresis is decreased. There are factors that increase the risk of presenting this disease: prematurity (more frequently at a lower gestational age), cesarean section without labor, history of respiratory distress syndrome in previous children, maternal hemorrhage prior to delivery, perinatal asphyxia, child of a mother diabetic, erythroblastosis fetalis. Among the appropriate treatments used for respiratory distress syndrome are continuous positive pressure, mechanical ventilation and the use of exogenous surfactant, which vary the course of the disease and have a significant impact on morbidity and mortality. The presence of surfactant in amniotic fluid is related to the degree of fetal lung maturity. Chest radiography is essential in the diagnosis; the characteristic radiological image shows increased homogeneous lung density. Blood gas determination shows oxygen requirements that rapidly necessitate inspired fraction of oxygen above 30-40%. Depending on the severity of the case, there may be respiratory and/or metabolic acidosis. The clinical and radiological picture can be identical: it helps to differentiate the perinatal history and the rapidly progressive evolution and with a greater tendency to cardiovascular compromise in the case of pneumonia. In the first hours after birth, transient neonatal tachypnea must also be differentiated, in which the course is more favorable and the patient has adequate lung volume. Current therapy focuses on the main preventive measures such as good prenatal control. In case of threat of premature birth, measures should be taken to prolong the pregnancy, the appropriate use of medications that inhibit labor, the use of steroids in the pregnant mother to produce lung maturation. All of these measures help decrease the incidence of RDS. During her hospitalization, the care applied to pregnant women is aimed at improving survival, as well as reducing the risk of premature birth and its morbidity. | es_ES |
| dc.description | Respiratory distress syndrome, also called hyaline membrane disease, is the most common pathology in the Neonatal Intensive Care Unit, it occurs in preterm newborns and is the main cause of morbidity and mortality of respiratory origin. Its incidence is reported in 5 to 10% of newborns and this increases significantly at a lower gestational age, with a higher incidence in patients weighing less than 1,200 g and 30 weeks of gestation, this disease is caused by a lack of pulmonary surfactant, a substance that Its main function is to reduce the surface tension forces of the alveoli and maintain the stability and volume of the lungs during expiration. Due to the deficiency of surfactant there is a tendency to alveolar collapse; this produces progressive atelectasis, intrapulmonary circulatory shunt, and hypoxemia. Clinically, it is characterized by progressive early-onset respiratory distress, from birth or in the first 6 hours of life. This respiratory distress is manifested by generally audible grunting, nasal flaring, xiphoid retraction, polypnea, and rapidly increasing FiO2 (fraction of inspired oxygen) requirements. The vesicular murmur is usually diminished, as well as the anteroposterior diameter of the thorax; in severe cases, there is thoracoabdominal dissociation. Edema is often present, and diuresis is decreased. There are factors that increase the risk of presenting this disease: prematurity (more frequently at a lower gestational age), cesarean section without labor, history of respiratory distress syndrome in previous children, maternal hemorrhage prior to delivery, perinatal asphyxia, child of a mother diabetic, erythroblastosis fetalis. Among the appropriate treatments used for respiratory distress syndrome are continuous positive pressure, mechanical ventilation and the use of exogenous surfactant, which vary the course of the disease and have a significant impact on morbidity and mortality. The presence of surfactant in amniotic fluid is related to the degree of fetal lung maturity. Chest radiography is essential in the diagnosis; the characteristic radiological image shows increased homogeneous lung density. Blood gas determination shows oxygen requirements that rapidly necessitate inspired fraction of oxygen above 30-40%. Depending on the severity of the case, there may be respiratory and/or metabolic acidosis. The clinical and radiological picture can be identical: it helps to differentiate the perinatal history and the rapidly progressive evolution and with a greater tendency to cardiovascular compromise in the case of pneumonia. In the first hours after birth, transient neonatal tachypnea must also be differentiated, in which the course is more favorable and the patient has adequate lung volume. Current therapy focuses on the main preventive measures such as good prenatal control. In case of threat of premature birth, measures should be taken to prolong the pregnancy, the appropriate use of medications that inhibit labor, the use of steroids in the pregnant mother to produce lung maturation. All of these measures help decrease the incidence of RDS. During her hospitalization, the care applied to pregnant women is aimed at improving survival, as well as reducing the risk of premature birth and its morbidity. | es_ES |
| dc.description.abstract | El síndrome de dificultad respiratoria también llamado enfermedad de membrana hialina, es la patología más común en la Unidad de Cuidados Intensivos Neonatales, se presenta en recién nacidos pretérmino y es la principal causa de morbimortalidad de origen respiratorio. Su incidencia se reporta en 5 a 10% de los recién nacidos y este aumenta significativamente a menor edad gestacional, con incidencia mayor en pacientes con peso menor de 1,200 g y 30 semanas de gestación, esta enfermedad es producida por falta de surfactante pulmonar, sustancia que tiene como función principal reducir las fuerzas de tensión superficial de los alvéolos y mantener la estabilidad y el volumen de los pulmones en la espiración. Debido a la deficiencia de surfactante existe tendencia al colapso alveolar; ello produce atelectasia progresiva, cortocircuito circulatorio intrapulmonar e hipoxemia. Clínicamente se caracteriza por presentar dificultad respiratoria progresiva de aparición precoz, desde el nacimiento o en las primeras 6 horas de vida. Esta dificultad respiratoria se manifiesta por quejido generalmente audible, aleteo nasal, retracción xifoidea, polipnea y requerimientos de la FiO2 (fracción inspirada de oxígeno) que van en rápido aumento. El murmullo vesicular suele auscultarse disminuido, así como el diámetro anteroposterior del tórax; en casos graves, existe disociación toracoabdominal. Con frecuencia hay edema y la diuresis se encuentra disminuida. Existen factores que aumentan el riesgo para presentar esta enfermedad, la prematurez (mayor frecuencia a menor edad gestacional), cesárea sin trabajo de parto, antecedente de síndrome de dificultad respiratoria en hijos previos, hemorragia materna previa al parto, asfixia perinatal, hijo de madre diabética, eritroblastosis fetal. Entre los tratamientos apropiados que se utilizan para el síndrome de dificultad respiratoria están la presión positiva continua, la ventilación mecánica y el empleo de surfactante exógeno, los cuales estos varían el curso de la enfermedad e inciden significativamente en la morbimortalidad. La presencia de surfactante en líquido amniótico se relaciona con el grado de madurez pulmonar del feto. La radiografía de tórax es esencial en el diagnóstico; la imagen radiológica característica muestra aumento de la densidad pulmonar homogénea. La determinación de gases en sangre muestra requerimientos de oxígeno que rápidamente necesitan fracción inspirada de oxígeno sobre 30-40%. Dependiendo de la gravedad del caso, puede existir acidosis respiratoria y/o metabólica. El cuadro clínico y radiológico puede ser idéntico: ayuda a diferenciar los antecedentes perinatales y la evolución rápidamente progresiva y con mayor tendencia al compromiso cardiovascular en el caso de la neumonía. En las primeras horas del nacimiento, también debe diferenciarse la taquipnea neonatal transitoria, en la cual el curso es más favorable y el paciente presenta adecuado volumen pulmonar. La terapéutica actual se centra en las principales medidas preventivas como un buen control prenatal. En caso de amenaza de parto prematuro se deben tomar medidas que prolonguen el embarazo, el uso adecuado de medicamentos que inhiben el trabajo de parto, empleo de esteroides en la madre gestante para producir maduración pulmonar. Todas estas medidas ayudan a disminuir la incidencia de SDR. Durante su hospitalización los cuidados que se apliquen en la embarazada van encaminadas a mejorar la supervivencia, así como disminuir riesgo de parto prematuro y su morbilidad. | es_ES |
| dc.format.extent | 31 p. | es_ES |
| dc.language.iso | es | es_ES |
| dc.publisher | Babahoyo: UTB-FCS, 2022 | es_ES |
| dc.rights | Atribución-NoComercial-SinDerivadas 3.0 Ecuador | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/ec/ | * |
| dc.subject | Síndrome Respiratorio | es_ES |
| dc.subject | Neonato | es_ES |
| dc.subject | Prematuro | es_ES |
| dc.subject | Saturación | es_ES |
| dc.subject | Surfactante | es_ES |
| dc.title | Proceso de atención de enfermería aplicado en neonato con síndrome de dificultad respiratoria. | es_ES |
| dc.type | bachelorThesis | es_ES |
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