P. Fister
Klinični oddelek za neonatologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija
J. Gržinić
Klinični oddelek za neonatologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija
A. Gubanc
Klinični oddelek za neonatologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija
Abstract
Congenital heart defects (CHD) represent the most common group of congenital anomalies. Early diagnosis of critical CHD in newborns significantly improves treatment outcomes and survival. The three main clinical signs of CHD in newborns are central cyanosis, tachypnoea and reduced tissue perfusion. With investigations, we try to differentiate between CHD, lung disease and persistent pulmonary hypertension. Blood tests with blood gas analysis are performed, arterial blood oxygen saturation and arterial blood pressure are measured in all four limbs, the electrocardiogram is recorded and a chest X-ray is taken. The paediatric cardiologist makes the definitive diagnosis of CHD with the heart ultrasound. While treating the newborn with CHD, the airway, breathing and circulation are maintained to provide a suitable arterial blood pressure and arterial blood oxygen saturation to enable balanced systemic and pulmonary circulations. Nursing care of a newborn with CHD is intensive and complex, requiring a multidisciplinary approach involving a physician, nurse, dietician, physiotherapist and psychologist. The newborn with CHD requires a comprehensive and individual approach by the medical and nursing team. If the newborn has ductal-dependent CHD, blood flow is established by opening the ductus using prostaglandin E1 (PGE-1). The nurses caring for the newborn treated with PGE-1 must carefully and frequently observe his behaviour and measure the vital signs so that side effects of treatment can be observed early enough.
Key words: congenital heart defects, screening, pulse oximetry, cyanosis, respiratory distress, treatment, healthcare, prostaglandin E1.