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Summary
The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at birth and the difficulties involved in recognising and treating hypoglycaemia. In the second part of the series the two other elements of the triangle, hypoxia and hypothermia, will be addressed.
Keywords
Neonates, Thermoregulation, Metabolism, Physiology
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Aim and intended learning outcomes
The aim of this two part article is to introduce the neonatal energy triangle (see Figure 1) a conceptual framework which can be used for the early care of the preterm baby on admission to the neonatal unit (NNlI). The focus is the transition period of the first six to ten hours of life. The transition period is more than simply a period of time, it is a process of physiological change for the newborn baby that begins in utero as the fetus prepares for transition from intrauterine placental support to extrauterine self-maintenance.
The neonatal energy triangle provides a framework which presents a logical yet integrated physiological overview of the three most common difficulties encountered by the preterm baby in this period. These are the 3Hs; hypothermia, hypoglycaemia and hypoxia. The 3Hs can each have detrimental physiological effects independently (Wen et al 2004). However, the consequential or accumulating impact of short falls in all three, unless interrupted will invariably lend to serious developmental impairment or death (Wen et al 2004).
Neonatal care is discussed with the expectation that the reader already has a sound grasp of the principles of neonatal care. After reading these two articles and undertaking the exercises within them you should he able to:
* Describe mechanisms of glucose homeostasis, respiratory adaptation and thermostasis in the preterm baby
* Summarise how the mechanisms above inter-relate with each other
* Analyse the main aims of assessment...