Proteins and phospholipids combine to form pulmonary surfactant. It is a chemical that the lungs manufacture and release. It decreases surface tension and lubricates the alveolar surfaces. This keeps the alveolar walls from adhering together during exhalation, which avoids alveolar collapse. Because optimal surfactant synthesis develops later in gestation, preterm babies fewer than 32 weeks are more likely to have surfactant deficits. Pulmonary surfactant deficiency is the most common cause of neonatal respiratory distress syndrome.
For enteral feedings, a typical, developing preterm infant's total daily calorie need is between 105-120 kcal/kg/day. Human milk and normal formula have a calorie content of 20 kcal/oz. Preterm formulations fortified with 22-24 kcal/oz. Human milk or formula at half strength contains 10 kcal/oz. Parenteral dietary needs are approximately 20% lower, ranging from 85-100 kcal/kg/day. Many aspects are considered while establishing an infant's proper calorie intake, including activity, body temperature, and stress level. Infants who are under stress (such as those who have just had surgery) will require extra calories per day.
A newborn may require mechanical ventilation for a variety of reasons. To establish if mechanical ventilation is required, all elements of respiratory function must be considered. Signs of approaching respiratory failure (respiratory rate more than 60/min, retractions, grunting, nasal flaring), apnea, and the presence of current respiratory failure are general criteria. Other causes that may necessitate artificial ventilation include congenital defects that interfere with breathing, sick newborns, and infants weighing less than 1000 g.
Hemolysis, increased liver enzymes, and low platelet count make up the HELLP syndrome, a trio of unique maternal hematologic abnormalities. HELLP syndrome is thought to occur in roughly 1 in every 1500 normal pregnancies and in up to 20% of women with preeclampsia or eclampsia. The causes of the illness is unknown, and it is frequently misidentified as other illnesses or health issues. Because the only effective therapy for HELLP syndrome is infant delivery, the risk of preterm birth is significant.
It is always a good idea to organize a lactation consult when releasing any newborn whose mother intends to nurse at home. By offering a professional/competent source of evaluation, encouragement, training, and troubleshooting, this will guarantee the best possibility for successful home nursing. It is not essential to arrange for physical/occupational treatment or any durable medical equipment at this time because this child is not going home with any special equipment and is not demonstrating any physical difficulties that require therapy. However, it is critical to educate parents/caregivers on the potential developmental problems associated with preterm. Encourage the parents to contact their doctor if they have any questions or concerns.
A neonate's normal body temperature range is 36.5-37.5 °C (97.7-99.5 °F). The World Health Organization defines hyperthermia as a core body temperature more than 37.5 °C. The other responses imply a hyperthermic condition, but they are not used to determine hyperthermia.
Nasal cannulas are ideal for newborns who require less than 1 lpm (liter per minute) of O2. Cannulas will also enable continuous bottle feeding. Infant nasal cannulas can only deliver less than 1 lpm of oxygen. Infants requiring higher flow rates or FiO2 concentrations greater than 0.4 (40%) will require other administration strategies.
