Yu nyu bɔbɔ gɛt prɔblɛm fɔ blo? Lɛ wi lan bɔt PPHN (Persistent Pulmonary Hypertension of the Newborn)!

We dɛn jɔs bɔn pikin na wan pan di tin dɛn we kin mek pɔsin gladi pas ɔl na layf, nɔto so? Bɔt i nɔmal bak fɔ fil smɔl fred ɛn wɔri, mɔ bɔt di pikin in wɛlbɔdi. Sɔntɛnde, pikin dɛn we dɛn jɔs bɔn kin gɛt sɔm prɔblɛm dɛn fɔ blo. Dat na siriɔs kɔndishɔn, bɔt na wan we wi ɔl kin ebul fɔ manej fayn if wi ɔl no bɔt. Lɛ wi tɔk bɔt am jɔs tide.

Wetin na PPHN? Wetin rili na am?

Fɔ tɔk am simpul wan, PPHN na siriɔs prɔblɛm fɔ blo we kin apin to pikin dɛn we dɛn jɔs bɔn. i kin apin we yu pikin kכmכt na yu bכdi εn bigin fכ brith na di say we de na do, εn di say we dεn de kכl di bכdi nכ de adap fayn.

Tink bɔt am dis we. we yu pikin de na yu bכdi, i de gεt in כksijεn tru di כmbilikal kכd, tru di plasεnta. Da tɛm de, nɔto bɔku blɔd kin go na in lɔng. dis na biכs di bכdi vεsεl dεm na di lכng (pulmonary arteries) kin blכk εn sכm tεm. Sɔm blɔd kin pas di lɔng dɛn ɛn go dairekt to di ɔda pat dɛn na di bɔdi. I tan lɛk se yu de tek difrɛn rod we dɛn dɔn blok rod.

Bɔt big chenj fɔ apin jɔs afta dɛn bɔn di pikin ɛn tek in fɔs briz . afta dat, di bכdi vεsul dεm na di lכng dεm we dεn bin kכl nid fכ opin (`(dilate)`). Na da tɛm de ɔksijɛn kin go insay di lɔng dɛn wit di briz. Dɔn, di blɔd kin go na di lɔng dɛn tru dɛn blɔd vesel dɛn ya we opin, i kin tek ɔksijɛn, ɛn sheb da blɔd de we ful-ɔp wit ɔksijɛn to di wan ol bɔdi, mɔ to di bren, at, ɛn kidni dɛn.

insay wan kכndyushכn we dεn kכl PPHN, di bכdi vεsεl dεm na di pikin in lכng dεm nכ de opin fayn, כ nכ de opin inof. Wetin kin apin da tɛm de? di ay blכd prεshכn na di lכng dεm (pulmonary hypertension) de divεlכp. Dis kin mek di ɔksijɛn nɔ rich di pikin in bren ɛn ɔda impɔtant pat dɛn. Dis na mɛdikal imejensi we de mek pɔsin in layf de pan denja ɛn dɛn nid fɔ bigin fɔ trit am wantɛm wantɛm.

Aw kכmכn dεn kכl dis kכndyushכn PPHN?

PPHN kin apin pan lɛk 2 pan ɛvri 1,000 pikin dɛn we dɛn bɔn layf layf wan. i kin kכmכn bכku pan pikin dεm we dεn bכn we dεn bכn (bitwin 37 εn 42 wik) εn pan pikin dεm we dεn bכn leta pas di de we dεn bכn (afta 42 wik). Bɔt i nɔ kin rili apin to pikin dɛn we dɔn bɔn ful-ɔp.

Wetin na di sayn dɛm fɔ PPHN? Aw wi kin no am?

If yu pikin gɛt PPHN, dɛn kin sho sɔm sayn dɛn lɛk:

• difεlεns fכ brith: yu de brith tu fast כ tu slo, yu de mek sawnd we yu de blo we yu de blo, εn fכ fil lεk yu chεst de sink insay (`(retractions)`).
• Inkrεs hat rεt (`(Rapid hat rεt)`).
• di pikin in skin kin tan lεk blu (cyanosis), spεshal wan na di say dεm lεk di lip, in tכng, εn di finga dεm.
• Lɔw blɔd prɛshɔn (haypɔtɛnshɔn).
• Insay di blɔdDi ɔksijɛn we de na di blɔd we nɔ bɔku .
• Fɔ yɛri ɛkstra ɔ ɔnusual sawnd (`(at murmur)`) we yu de lisin to di at.

If yu notis wan ɔ mɔ pan dɛn sayn ya jɔs afta dɛn bɔn di pikin, ɔ insay sɔm awa, i rili impɔtant fɔ tɛl di dɔktɔ dɛn wantɛm wantɛm.

Wetin na di tin dɛm we de ɛp fɔ mek PPHN divɛlɔp?

di wan dεm we de du risach stil nכ sכht wetin rili de mek PPHN, bכt dεn tink se i de kכz di pikin in lכng dεm we nכ de divεlכp fayn כ we i nכ ebul fכ adap (opin) to di εvayroment we de na do afta dεn kכmכt na di bεlε.

Us tin dɛn kin mek pɔsin gɛt PPHN?

Pan ɔl we dɛn nɔ no di rayt tin we kin mek i gɛt PPHN, sɔm tin dɛn kin mek di pikin gɛt PPHN. Lɛ wi tek wan luk pan wetin dɛn bi:

• `Meconium aspiration` : dis na we di pikin in fכs stכl (wi kכl am `(Meconium)`, we tik sכmtεm εn stika) de go insay in rεspiretכri sistεm we i stil de insay di bεlε.
• Infεkshכn: Infεkshכn na di lכng, lεk nyumonia, כ infεkshכn na di bכdi.
• Respiratory distress syndrome (RDS): Dɛn kin si dis mɔ pan pikin dɛn we dɛn bɔn bifo tɛm we dɛn lɔng nɔ dɔn ful-ɔp.
• Asfiksia we dɛn bɔn: Na pikin we nɔ de gɛt bɛtɛ ɔksijɛn bifo ɔ we dɛn bɔn am.
• di dayafragmatik hεnia: dis kin apin we wan ol de fכm na di mכsul we de separet di pikin in chεst εn bכdi (dεn kכl am dayafragm). dis kin mek sכm pan di bכdi כgan dεm fכ push tru di ol insay di chεst.
• Ɔda tin dɛn we kin apin we pɔsin bɔn wit at ɔ lɔng: Fɔ ɛgzampul, smɔl lɔng ɔ at valv we dɔn blok.
• yus fכ sכm mεdikeshכn dεm we uman bεlε: dεn bin sכgεst se di yus כf mεdikeshכn dεm we dεn kכl ``NSAIDs`` (nonsteroidal anti-inflammatory drugs) εn ``SSRIs`` (selective serotonin reuptake inhibitors), spεshal wan we uman bεlε let, kin afekt bak. So if yu de tek ɛni mɛrɛsin we yu gɛt bɛlɛ, i rili impɔtant fɔ tɔk to yu dɔktɔ bɔt am.

Wetin na di lɔng tɛm ifɛkt dɛm we PPHN gɛt?

bכt wan pan fכ (1 pan 4) pikin dεm we de liv pan PPHN de divεlכp sכm digri fכ disabiliti bikoz dεn nכ gεt כksijεn na di bren. Dɛn kɔmplikeshɔn ya na:

• Divɛlɔpmɛnt dilɛys dɛn .
• Di prɔblɛm dɛn we pɔsin kin yɛri , sɔntɛnde ivin dɛf, kin apin.
• Disabiliti fɔ lan .
• I nɔ ebul fɔ du bɔku tin dɛn we pɔsin kin du fɔ mek i nɔ ebul fɔ du bɔku tin dɛn .

So, i rili impɔtant fɔ kɔntinyu fɔ kip di pikin dɛn we dɔn wɛl frɔm PPHN ɔnda dɔktɔ in sɔpɔtishɔn ɛn fɔ wach aw dɛn de gro.

Aw dɛn kin no se pɔsin gɛt PPHN?

Yu pikin in dɔktɔ kin du difrɛn tɛst fɔ no if yu pikin gɛt PPHN. Sɔm pan dɛn tin ya na:

• Complete blood count (CBC): Dis de sho di nɔmba fɔ di wayt blɔd sɛl dɛn, di rɛd blɔd sɛl dɛn, ɛn di pletlɛt dɛn we de na di pikin in blɔd.
• Pulse oximetry (pulse ox): dis na simpul we we nכ de invayd fכ mכsu di כksijεn lεvεl na di pikin in bכdi.
• di atεrial bכdi gas (ABG): Dis de mכsu aw di pikin in bכdi de gεt כksijεn fayn fayn wan εn aw i de pul di kabכn dayכksayd fayn fayn wan.
• Chɛst ɛkstrem rayt: Dis kin ɛp fɔ si if di pikin in at dɔn big ɔ if ɛni prɔblɛm de na in lɔng.
• Echocardiogram (echo): Dis na ditayla ɔltra saund fɔ di pikin in at. I de asɛs aw blɔd de flɔ to di at ɛn di lɔng.
• Ɛd ɔltrasɔund: Dis kin ɛp fɔ chɛk if ɛni blɔd de kɔmɔt na di pikin in bren.
• di sεrum εlektrolayt tεst dεm: dεn kin yuz dεn tεst dεm ya fכ chεk di bεlε fכ di minral dεm we de na di pikin in bכdi.
• lכmba pankshכn (spinal tap): sכmtεm dεn kin du dis tεst fכ chεk if di pikin gεt εni infεkshכn.

I nɔ nid fɔ du ɔl dɛn tɛst ya; di dכkta dεm go disayd us tεst dεm fכ du bay di pikin in kכndishכn.

Aw dɛn kin trit PPHN?

di men gol fכ trit PPHN na fכ inkrεs כksijεn fכ fכlכ di pikin in כgan dεm εn fכ mek i nכ gεt siriכs kכmplikεshכn dεm. Difrɛn tritmɛnt dɛn de fɔ dis:

• כksijεn: dεn kin gi di pikin 100% כksijεn tru wan kanula na in nos, di nos prong dεm, כ mask.
• Mekanikal ventilashɔn: Dɔktɔ kin put tiub insay di pikin in winda paip (trachea) ɛn yuz ventilatɔ fɔ ɛp di pikin fɔ blo.
• fכ kכntro di bכdi prεshכn: dεn kin gi di pikin mεdikeshכn fכ kכntrכl bכdi prεshכn tru wan vein (`(IV)`).
• Nitric oxide: Nitric oxide na gas we de ɛp fɔ opin (dilate) di blɔd vesel dɛm na yu pikin in lכng, we de mek di bכdi fכ fכlכ to di lכng.
• High-frequency oscillatory ventilation: Dis na spɛshal kayn ventileshɔn bak. I kin ɛp fɔ mek di ɔksijɛn we de na di pikin in blɔd bɛtɛ.
• Extracorporeal membrane oxygenation (ECMO): Dɛn kin yuz dis mashin we di pikin in at ɔ in lɔng dɛn tu wik fɔ mek ɔda tritmɛnt dɛn ebul fɔ kɔntrol am. I de tek blɔd na di pikin in bɔdi fɔ sɔm tɛm, ad ɔksijɛn to am, ɛn gi am bak to di bɔdi, ɛn gi ɔksijɛn to di bren ɛn ɔda pat dɛn na di bɔdi. I de wok lɛk atifishal lɔng.

Wi kin ebul fɔ mek PPHN nɔ apin?

As wi bin dɔn tɔk bifo tɛm, no we nɔ de fɔ mek wi nɔ gɛt PPHN kpatakpata bikɔs wi nɔ no bɛtɛ bɛtɛ wan wetin kin mek i gɛt am . Bɔt if yu avɔyd sɔm mɛrɛsin dɛn we yu gɛt bɛlɛ, dat kin ɛp fɔ mek yu nɔ gɛt bɔku prɔblɛm. So, if yu gɛt bɛlɛ, mek shɔ se yu tɔk to yu dɔktɔ bifo yu tek ɛni mɛrɛsin fɔ mek shɔ se i nɔ bad fɔ tek am we yu gɛt bɛlɛ.

Aw lɔŋ e kin tek fɔ wɛl frɔm PPHN?

Bɔku pikin dɛn kin wɛl frɔm PPHN insay wan ɔ tu wik . Bɔt sɔm pikin dɛn kin tek lɔng tɛm, sɔm tɛm dɛn kin tek sɔm mɔnt fɔ mek dɛn wɛl ɔl. Ivin afta yu pikin dɔn wɛl, i impɔtant fɔ protɛkt am frɔm kol, flu, ɛn ɔda vayral infɛkshɔn. Dis kin bi bay wae yu de was yu an ɔltɛm, nɔr de mek yu pikin nɔ de nia krawd, ɛn mek yu pikin nɔ de nia pipul dɛm we sik. I fayn bak fɔ mek ɔlman na yu os gɛt di flu vaysin ɛvri ia.

Na mɔ, i impɔtant fɔ kɛr yu pikin go fɔ mek dɛn go chɛk yu pikin ɔltɛm ɛn fɔ go to spɛshal pipul dɛn fɔ mek shɔ se dɛn de divɛlɔp fayn fayn wan.

Wetin na di sɔvayv rɛt ɛn di lukin-grɔn fɔ PPHN?

PPHN na siriɔs sik, ɛn i sɔri fɔ no se, bitwin 7% ɛn 10% pan di pikin dɛn we gɛt dis sik kin day bikɔs ɔf kɔmplikeshɔn. pan di pikin dεm we de liv, lεk 25%, כ lεk wan pan fכ, kin gεt lכng tεm ifekt dεm (lεk we dεn de dilay fכ divεlכpmεnt, we dεn de lan disabiliti, εn we dεn nכ de yεri) we dεn nכ de gεt כksijεn na di bren.

Ustɛm yu fɔ kɛr yu pikin go to dɔktɔ?

Afta yu pikin dɔn wɛl frɔm PPHN, mek shɔ se yu kɛr yu pikin go ɔl di fɔlɔp apɔntinmɛnt dɛn . Dis go ɛp yu dɔktɔ fɔ kɔntinyu fɔ wach yu pikin. Insay dis tɛm, go to dɔktɔ wantɛm wantɛm if yu pikin sho ɛni wan pan dɛn sik ya:

• If yu gɛt fiva.
• If yu ridyus di milk we yu de it, ɔ if yu nɔ de drink milk atɔl.
• If yu chɛst de sink insay we yu de blo, ɔ if yu de blo wit yu nos dɛn we opin.
• If yu mek sawnd we yu de wis ɔ grɔmbul we yu de blo.
• If di skin bigin fɔ tɔn blu ɔ grey.

We yu kam fɔ no se yu nyu bɔbɔ gɛt wan sik lɛk PPHN, i nɔmal fɔ fil miks pan sɔri-at, fred, vɛks, ɛn kɔnfyushɔn. Dat na tin we nɔmal. Lan as yu ebul bɔt PPHN frɔm di dɔktɔ ɛn nɔs dɛm we de trit yu pikin. Dɛn go tɛl yu ɔl wetin yu ebul fɔ tɛl yu pikin in kɔndishɔn, ɛn aw yu go kɔrej ɛn ɛp am. As tɛm de go, yu go bi pɔsin we sabi bɔt yu pikin in kɔndishɔn, ɛn yu go gɛt kɔnfidɛns fɔ du ɔl wetin yu ebul fɔ yu pikin.

Impɔtant tin dɛn fɔ mɛmba (Take-Home Message) .

• PPHN na siriɔs prɔblɛm fɔ blo we pikin dɛn we dɛn jɔs bɔn. pan dis kכndyushכn, di bכdi vεsul dεm na di lכng dεm nכ de opin fayn, we de mek di bכdi nכ de gεt inof כksijεn.
• Pan ɔl we dɛn nɔ no yet di rayt tin we kin mek dis apin , sɔm tin dɛn de we kin mek pɔsin gɛt dis sik lɛk we pɔsin gɛt mɛkoniɔm, we i gɛt infɛkshɔn, RDS, ɛn we di ɔksijɛn nɔ kin bɔku we i de bɔn pikin.
• If yu gɛt sɔm kayn sik lɛk fɔ blo, yu skin de blu, ɔ yu at de bit kwik kwik wan, go to dɔktɔ wantɛm wantɛm.
• Di tritmɛnt dɛn na ɔksijɛn, sɔpɔt fɔ ventilatɔ, naytrik ɔksayd, ɛn ECMO.
• Pan ɔl we i nɔ pɔsibul fɔ mek yu nɔ gɛt am kpatakpata , i impɔtant fɔ tek sef mɛrɛsin nɔmɔ we yu gɛt bɛlɛ lɛk aw dɔktɔ tɛl yu.
• Lכng tεm mεdikal monitarin εn growth chεk impɔtant afta yu rεkכv.
• Nɔto yu wan de dis tɛm. Gɛt sɔpɔt frɔm dɔktɔ ɛn famili. Bɔku tin dɛn de we yu kin du fɔ yu pikin.

` PPHN, nyu bכn, rεspiretכri distres, pulmonari haypatεnshכn, כksijεn, nyu bכbi kia, saynosis