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運用低溫療法於新生兒窒息之照護經驗

Neonatal Asphyxia: A Care Experience Using Hypothermic Therapy

摘要


運用低溫療法治療新生兒缺氧缺血性腦病變,可降低窒息的新生兒發生相關的合併症及死亡率。本文為應用低溫療法於新生兒窒息之照護經驗,本病房因無冷卻裝置執行低溫治療,臨床實務上僅能使用增減冷水袋的數量、溫度以進行低溫療法,過程雖艱辛但也成功地挽救個案生命,照護過程中提供以家庭為中心的護理,使個案渡過疾病的急性期,也協助案父母面對個案病危所產生的焦慮與愧疚,使案父母能減輕焦慮、不安的情緒反應,並與個案建立起親子關係,達到整體性照護之護理目標。然而,低溫療法運用於新生兒尚處於初始階段,未來應建立相關照護標準以提供安全有品質的照護,使低溫療法能繼續應用於治療新生兒窒息的病人。

關鍵字

低溫療法 新生兒 窒息

並列摘要


Hypothermia therapy, used to treat hypoxic-ischemic encephalopathy in neonates, has been shown to effectively decrease asphyxia complications and mortality. This article reports on an experience using this therapy approach to care for a neonatal asphyxic patient. Due to our lack of an appropriate cooling device, we adjusted the number of cool water bags to successfully perform hypothermic therapy. Despite this added procedural complication, we succeeded in saving the patient's life. The holistic care process for this type of case requires family-centered care to help family members deal with the critical condition and assist parents to face depression and guilt, reduce anxiety, and reaffirm the parent-child relationship. We used hypothermia in the initial stage. Relevant standards of critical care for this condition should be established to ensure adequate nursing care safety and quality.

並列關鍵字

hypothermia therapy neonatal infant asphyxia

參考文獻


吳承學、劉慧玲(2011).低溫治療於心跳停止復甦後病人 之應用與照護.榮總護理,28(4),334-340。[Wu, C. H., & Liou, H. L. (2011). Hypothermia therapy and nursing care for cardiac arrest patients after resuscitation. VGH Nursing, 28(4), 334- 340.]
Cooper, D. J. (2011). Induced hypothermia for neonatal hypoxic- ischemic encephalopathy: Pathophysiology, current treatment, and nursing considerations. Neonatal Network: The Journal of Neonatal Nursing, 30(1), 29-35. doi:10.1891/0730-0832.30.1.29
Fegran, L., Helseth, S., & Slettebø, A. (2006). Nurses as moral practitioners encountering parents in neonatal intensive care units. Nursing Ethics, 13(1), 52-64. doi:10.1191/ 0969733006ne849oa
Horn, A., Thompson, C., Woods, D., Nel, A., Bekker, A., Rhoda, N., & Pieper, C. (2009). Induced hypothermia for infants with hypoxic-ischemic encephalopathy using a servo-controlled fan: An exploratory pilot study. Pediatrics, 123(6), e1090- e1098. doi:10.1542/peds.2007-3766
Horn, A. R., Harrison, M. C., & Linley, L. L. (2010). Evaluating a simple method of neuroprotective hypothermia for newborn infants. Journal of Tropical Pediatrics, 56(3), 172- 177. doi:10.1093/tropej/fmp089

被引用紀錄


賴靜怡、蕭慧玲(2020)。低溫治療知識發展里程碑彰化護理27(4),2-14。https://doi.org/10.6647/CN.202012_27(4).0002
魏妙純(2018)。一位新生窒息兒運用低溫療法之護理經驗助產雜誌(60),32-41。https://doi.org/10.6518/TJOM.201812_(60).0004
黃鈺婷、李銘櫻、廖虹雅、張鈞竹(2020)。提升新生兒加護病房護理人員執行低溫療法照護流程完整率護理雜誌67(4),72-80。https://doi.org/10.6224/JN.202008_67(4).09

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