Please enable JavaScript.

Coggle requires JavaScript to display documents.

Induction phase (การลดอุณหภูมิ โดยผิวทารกสัมผัสอุณหภูมิที่ต่ำกว่า…

- - - - การขาดสารน้ำจากหน้าที่ของไตเปลี่ยนแปลงและมีการขับน้ำออกจากร่างกายมากเกินไป (diuresis)
        
        เกิดภาวะความดันโลหิตต่ำ
        
        อัตราการเต้นของหัวใจลดลง
        
        Cardiac output ลดลง
        
        Hypoxemia
        
        Hypoxia
        
        2 more items...
    - - Monitor EKG
        
        sinus Tachycardia
        
        A drop in body temperatureShift of circulating blood volume from the peripheral circulation to the central circulation and also an increase in venous return.
        
        ventricular tachycardia (VT)
        
        ventricular fibrillation (VF)
        
        atrial fibrillation (AF)
    - - Diastolic and systolic dysfunction
        
        Cardiac output ลดลง
    - - At the time of induction of hypothermia
        
        Body uses several mechanisms to obtain and maintain the heat
        
        Increasing sympathetic tone and vasoconstriction of skin and uses shivering to generate heat
        
        Neuromuscular blockade
      - Increases oxygen consumption
        
        has adverse effects on patients with neurological injuries and damages caused by hypoxia
      - Increases metabolic activity
    - - results from increased venous return stemming from vasoconstriction
        
        decreased antidiuretic hormone levels, and tubular dysfunction
        
        increase urine output
        
        hypotension.
- - - - Pancreatitis
        
        decreases insulin sensitivity and also decreases insulin secretion by the pancreas
        
        Increase Amylase
        
        ประสิทธิภาพ การทำงาน insulin ลดลง
        
        Hyperglycemia
  - - - platelets dysfunction
        
        This increase is realized through the effect on the number and functions of platelets
        
        Throughout hypothermia, platelets become sequestrated in the spleen and liver and reenter the circulation after rewarming
        
        bleeding
      - production of clotting enzymes dysfuction
      - tissue plasminogen activator inhibitor enzyme
  - - - occurs because of the increased renal excretion of electrolytes and the resulted intracellular shift
        
        The reason for the increased renal excretion includes changes in volume adjustment in blood circulation
        
        cardiac preload and also impaired tubular function.
        
        Magnesium deficiency is associated with atrial and ventricular arrhythmia, bronchospasm, seizures and metabolic effects such as insulin resistance.
        
        Magnesium deficiencyis is associated with myocardial infarction
        
        Magnesium deficiency can also lead to other electrolyte abnormalities such as hypokalemia, hypocalcemia, hyponatremia, hypophosphatemia
        
        Particularly magnesium deficiency
        
        Magnesium deficiency in patients with brain trauma may cause adverse neurological outcome
  - - - Respiratory alkalosis and hypocapnia
  - - - Diuresis would be associated with fluid and electrolyte imbalance
        
        Hypotension
        
        Throughout rewarming, electrolytes would shift to the extra-cellular compartment and increase plasma concentrations
    - - This situation in combination with other mechanisms such as tubular dysfunction increases the urine output which is known as “cold diuresis.”
        
        hypovolemia, renal excretion of electrolytes, hemoconcentration
        
        elevated levels of sodium and serum osmolality
      - Polyuria
  - - - Hypothermia inhibits the secretion of cytokines and suppresses the migration of leukocytes and phagocytes
  - - - เอนไซม์ไซโตโครม พี450 (cytochrome p450) มีปริมาณน้อยลง
        
        ทำให้ยาที่ต้องถูกทำลายโดยเอนไซม์ตัวนี้มีฤทธิ์ยาวนานขึ้น
        
        กลุ่มยาสงบประสาทและยาสกัดกั้นประสาทกล้ามเนื้อหรือยาทำให้กล้ามเนื้ออัมพาต
- - - - causes dangerous electrolyte shifts out of the cells back into the serum during rewarming
        
        the kidneys to excrete excess potassium
        
        hyperkalemia
        
        Arrhythmias