(if available)

RESPIRATORY DISTRESS EVALUATION Downe Score

0 1 2 Respiratory Rate

< 60x/minute 60-80 x/minute >80x/minute

Retraction No retraction Mild retraction Severe Retraction

Cyanosis No cyanosis Cyanosis disapeared with O2

Cyanosis (+) with O2

Air Entry (+) Air entry decrase NO air entry

Gasping No gasping Dapat didengar dengan stetoskop

Dapat didengar tanpa alat bantu

3

Score < 4 Mild Respiratory Distress

Score 4 – 5 Moderate Respiratory Distress

Score > 6 Severe Respiratory Distress (blood gas analysis should be performed)

4

RESPIRATORY DISTRESS EVALUATION … Downe Score

Apnoea Definition

Neonatal Handbook, Royal Women Hospital 2005

Apnoea is defined as no inspiratory gas flow for 20 seconds or shorter if associated with bradycardia (<100bpm), cyanosis or pallor.

Aminophylline Neonatal Apnoea Loading dose IV : 6 mg/kg/dose Maintenance dose Commence ≤ 1 kg 24 hrs after loading 1 kg 12 hrs after loading IV : Age ≤ 7 days 2.5 mg/kg/dose 12 hrly Age 8-14 days 3 mg/kg/dose 12 hrly Age >14 days 4 mg/kg/dose 12 hrly

Coffeine Citrate

Neonatal Apnoea •  Loading dose IV, Oral : 20 mg/kg •  Maintenance dose (commence 24 hrs after loading dose) IV, Oral : 5 mg/kg/daily Maintenance dose can be increased to a

maximum of 10 mg/kg/day

88-92%

36

RESPIRATORY DISTRESS EVALUATION Downe Score

Mild RD → nasal O2 (0,5-2L) – headbox (3-5L) depend on clinical appearance and Sp O2

target =88 – 92% (for all gestational age/birth weight)

Moderate RD → mostly need CPAP, while CPAP prepared, can be given head box O2 5 L/min + nasalO2 up to 2 L/min

Severe RD threat of respiratory failure → ventilator support immediately

NNF Teaching Aids:Newborn Care