Pediatric emergency medicine trisk 2464 2464
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (100.13 KB, 1 trang )
vascular resistance and influence the direction and degree of intracardiac shunts,
potentially leading to congestive heart failure. Target saturations for this
population should be discussed with a cardiologist.
It is important to note that pulse oximetry measures are dependent on adequate
pulse pressure, and so any low perfusion state may lead to falsely low pulse
oximetry readings. Pulse oximetry is also unable to detect significant hyperoxia
or severe hypoxemia. The presence of other hemoglobin forms, such as
methemoglobin or carboxyhemoglobin, may not be detected by pulse oximetry. In
any of these circumstances, arterial blood sampling for PaO2 and cooximetry for
carboxyhemoglobin or methemoglobin may be needed to better understand the
infant’s respiratory physiology.
Blood Pressure
Blood pressure monitoring in the newborn requires specific equipment and
interpretation. Most commonly, indirect blood pressure monitoring utilizes an
occlusive cuff device that functions identically to pediatric and adult cuffs.
Neonatal blood pressure cuff width should measure approximately 50% of the
extremity circumference. A cuff that is too loose can result in inaccurate
measurement of blood pressure. To increase accuracy, the cuff should be placed at
the same level as the heart, typically in the upper extremity. Normal ranges for
blood pressure increase within the first few hours to days of life and are
dependent on the infant’s weight and gestational age at birth, and should be
interpreted accordingly ( Figs. 96.2 and 96.3 ).
