Asian Society of

Perioperative Pediatric
Pediatric
Life Support Course Anesthesiology

RESUSCITATION OF
BABIES AT BIRTH:
GUIDELINES OF 2015

Indonesian Society of Pediatric Anesthesia And Critical Care

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Asian Society of
Pediatric Anesthesia
 Definition
 This guidelines apply primarily to newly born infants
undergoing transition from intrauterine to extrauterine life,
but the recommendations are also applicable to neonates
who have completed perinatal transition and require
resuscitation during the first few weeks
 The term newly born is intended to apply specifically to
an infant at the time of birth
 newborn and neonate are intended to apply to any infant
during the initial hospitalization.

Asian Society of
Pediatric Anesthesia
Patofisiologi

Asian Society of
Pediatric Anesthesia
Neonatal Hypoxia

Asian Society of
Pediatric Anesthesia
 Primary Apnoea
• Caused by abnormal even lead to hypoxia
• Acute onset breathing becomes deeper and more rapid
• ↑ CO2, PaO2 ↓
• Consciousness lost
• Regular breathing ceases
• No change in heart rate initially, but soon starts to fall
• No significant drop in BP
• Baby in primary apnoea will respond to correcting airway and
stimulation
• May need oxygen

Asian Society of
Pediatric Anesthesia
 Secondary Apnoea
• Prolong ceased primary apnea
• Anaerob metabolism lead to acidosis
• If insult continues, primitive spinal centers produce whole body gasps
• baby starts to gasp
 CO is maintained
• If gasping does not aerate lungs, synaptic communication interfere
 Baby enters terminal or secondary apnoe
 Biochemical milieu rapidly deteriorating
 Will die without intervention
 May die despite intervention

Asian Society of
Pediatric Anesthesia
• PRIMARY and SECONDARY APNOEA may occur in
utero. It is not possible to distinguish at Birth
• So when dwelt with an apnoeic baby - consider it as a
Secondary Apnea and commence Resuscitation
• The longer the duration of Secondary Apnea - the greater
the damage to Brain
• The whole process probably takes up to 20 min in the
human fetus at term.

Asian Society of
Pediatric Anesthesia
Algorhytm

Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
 Asian Society of
Pediatric Anesthesia
TERIMA KASIH

Asian Society of
Pediatric Anesthesia