Aralin 1Noninvasive respiratory support modalities: nasal CPAP, NIPPV, HFNC—settings, interfaces, at contraindications sa 29-linggong infantsAng seksyong ito ay naglalarawan ng mga noninvasive respiratory support options para sa very preterm infants, kabilang ang nasal CPAP, NIPPV, at high-flow nasal cannula, na may diin sa settings, interfaces, contraindications, at practical considerations sa 29-linggong gestation infants.
Nasal CPAP: pressure settings at titrationNIPPV: indications at synchronization optionsHigh-flow nasal cannula: flow at FiO2 limitsPagpili ng prongs, masks, at interface sizeContraindications at failure indicatorsSkin care at pag-iwas sa nasal injuryAralin 2Technique ng positive pressure ventilation sa delivery room: T-piece resuscitator vs bag-mask, tidal volume targets, inspiratory time, peak inspiratory pressure guidance para sa maliliit na infantsAng seksyong ito ay naghahambing ng T-piece at self-inflating bag-mask ventilation sa delivery room, na nakatuon sa setup, mask seal, pressure control, at ligtas na targets para sa tidal volume, inspiratory time, at peak inspiratory pressure sa very preterm infants.
T-piece vs self-inflating bag: pros at consMask fit, positioning, at leak minimizationSetting PIP, PEEP, at inspiratory time nang ligtasTidal volume targets at monitoring optionsPagsusuri ng chest rise at clinical responseAralin 3Monitoring ng respiratory support: continuous heart rate, SpO2 targeting by postnatal minutes, transcutaneous/arterial blood gases, chest radiograph interpretationAng seksyong ito ay nagpapaliwanag kung paano i-monitor ang respiratory support gamit ang continuous heart rate at oxygen saturation, postnatal age–based SpO2 targets, blood gas sampling, transcutaneous monitoring, at chest radiograph interpretation upang gabayan ang ligtas na adjustments.
Continuous heart rate at ECG monitoringSpO2 targets by postnatal minute at ageTranscutaneous CO2 at oxygen monitoringArterial at capillary blood gas samplingChest radiograph signs ng overdistensionRadiographic assessment ng tube positionAralin 4Indications, timing, at methods para sa intubation sa very preterm infants; premedication considerations at pinakaliwas na techniqueAng seksyong ito ay nagdedetalye ng indications, timing, at methods para sa intubation sa very preterm infants, kabilang ang premedication options, equipment selection, pinakaliwas na laryngoscopy techniques, confirmation ng tube placement, at strategies upang mabawasan ang physiologic instability.
Clinical indications at optimal timingPagpili ng tube size at depth of insertionPremedication regimens at contraindicationsDirect versus video laryngoscopy techniquePagkukumpirma ng endotracheal tube placementPamamahala ng desaturation at bradycardiaAralin 5Surfactant therapy: indications, timing (early rescue vs prophylactic), dosing, administration techniques (INSURE, LISA/MIST), at expected responsesAng seksyong ito ay sumusuri ng surfactant therapy sa very preterm infants, na sumasaklaw sa indications, timing ng early rescue versus prophylaxis, dosing strategies, administration techniques tulad ng INSURE at LISA, at expected clinical at radiographic responses pagkatapos ng paggamot.
Clinical at radiographic indications para sa surfactantEarly rescue versus prophylactic strategiesWeight-based dosing at repeat dosing criteriaINSURE technique: steps at precautionsLISA at MIST: procedure at monitoringExpected response at nonresponse patternsAralin 6Decision framework: unang pagpili sa pagitan ng CPAP, positive pressure ventilation, at intubation batay sa respiratory drive, heart rate, at work of breathingAng seksyong ito ay nagpapakita ng practical decision framework para sa pagpili ng unang support—CPAP, positive pressure ventilation, o intubation—batay sa respiratory drive, heart rate, tone, work of breathing, at antenatal risk factors sa very preterm infants sa delivery room.
Pagsusuri ng respiratory drive at spontaneous effortPaggamit ng heart rate at tone upang gabayan ang desisyonWork of breathing at grunting evaluationKailan simulan ang CPAP bilang primary supportKailan magbigay ng brief positive pressure breathsKailan magpatuloy nang direkta sa intubationAralin 7Physiology ng preterm lung: surfactant deficiency, compliance, pulmonary vascular resistance, at transitional circulationAng seksyong ito ay sumusuri ng preterm lung physiology, na nagbibigay-diin sa surfactant deficiency, reduced compliance, high airway resistance, pulmonary vascular resistance, at transitional circulation, at nag-uugnay ng mga katangiang ito sa respiratory support strategies at risks ng injury.
Structural immaturity ng distal airwaysSurfactant deficiency at surface tensionCompliance, resistance, at time constantsPulmonary vascular resistance sa pretermsTransitional circulation at shunt patternsImplications para sa ventilator settingsAralin 8Mga komplikasyon ng respiratory support sa preterms: air leak, bronchopulmonary dysplasia risk factors, volutrauma/atelectrauma mitigation strategiesAng seksyong ito ay sinusuri ang mga komplikasyon ng respiratory support sa preterm infants, kabilang ang air leak syndromes, volutrauma, atelectrauma, oxygen toxicity, at bronchopulmonary dysplasia, at naglilinaw ng prevention, maagang pagkilala, at mitigation strategies sa NICU.
Pathophysiology ng air leak syndromesPagkilala at pamamahala ng pneumothoraxVolutrauma at atelectrauma mechanismsStrategies upang limitahan ang oxygen toxicityBronchopulmonary dysplasia risk factorsLung-protective ventilation approachesAralin 9Criteria para sa escalation (failure ng CPAP, persistent apnea/bradycardia, high oxygen/pressure requirements) at de-escalation weaning pathwaysAng seksyong ito ay naglilinaw ng criteria para sa escalation kapag nabigo ang CPAP o noninvasive support, kabilang ang persistent apnea, bradycardia, o high oxygen needs, at naglalarawan ng maayos na de-escalation at weaning pathways upang mabawasan ang instability at chronic lung injury risk.
Pagdefine ng CPAP failure sa very preterm infantsApnea, bradycardia, at desaturation thresholdsOxygen at pressure limits na nagpo-prompt ng escalationTransition mula CPAP sa NIPPV o intubationMaayos na CPAP at HFNC weaning protocolsMonitoring ng stability sa panahon ng step-down
