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In the fetus
In utero, the fetus is dependent on the
placenta as the organ of gas
exchange
Air sacs (alveoli) are filled with fetal
lung fluid
Oxygenation before birth
Oxygenation before birth
Lungs and Circulation
In the fetus
Arterioles are
constricted
Pulmonary blood
flow is diminished
Blood flow is
diverted across
ductus arteriosus
Lungs and Circulation
Impaired by
Apnea at birth with no lung expansion
After delivery
Pulmonary
arterioles dilate
(endothelin,
prostacyclin &
nitric oxide)
Pulmonary blood
flow increases
Lungs and Circulation
After delivery
Blood oxygen
levels rise
Ductus
arteriosus
constricts
Blood flows
through the
lungs to pick up
oxygen
Oxygenation After birth
Major changes within seconds after birth:
Late effects
Myocardial function may be impaired, cardiac
output decreases, and multiorgan damage may
occur
Primary & Secondary Apnea
10 Apnoea
Rapid attempts to breathe
Respirations
Respirations cease
Heart rate decreases
Blood pressure is usually
maintained
Heart rate
Responds to stimulation
20 Apnoea
Respirations cease
pressure
Bradycardia
Team concept
The ABCs of Resuscitation:
Heart Rate
Color
• Calcium homeostasis
• Hypocalcaemia
• Acid base balance and blood gas results
interpretation