How to properly provide oxygen to premature babies?

The mixed blessing today is that premature babies are becoming more and more common. Because their tissues and organs are immature, their functions are incomplete, their living ability is poor, and their resistance is low, we need to strengthen the care of premature babies. Premature babies have more physical problems than normal babies and need special care to be the same as normal babies. So, how should premature babies breathe oxygen correctly?

(1) In principle, oxygen should only be given to premature infants who are cyanotic, have difficulty breathing, or are in poor condition.

(2) Oxygen should be given only to relieve symptoms. Oxygen can be stopped when symptoms disappear. Oxygen can be given continuously if necessary, but it is best not to exceed 3 days. The flow rate should be the same as for rescuing asphyxia.

(3) The appropriate oxygen concentration is 38% to 40%. It is forbidden to administer oxygen too quickly. At present, we only rely on the clinical condition of the child to control the rate of oxygen administration, so as to relieve breathing difficulties and eliminate cyanosis.

(4) Use a small funnel to administer oxygen, with the bottom edge of the funnel close to the child’s nostrils. This is because oxygen is heavier and can easily flow down into the child’s nostrils. Catheter method: Insert the catheter about 1 cm into the nose. This is more comfortable and easier for the baby to accept. It can also reduce irritation and prevent oxygen from entering the stomach.

(5) For infants who easily cyanosis during feeding, oxygen inhalation can be given for a few minutes before and after feeding.

(6) Oxygen is most effective when it is passed through a humidifier bottle at a water temperature of around 45°C. If the humidity of the inhaled oxygen is not enough, additional humidity may be required using a nebulizer or steam. Oxygen that is not heated and humidified will rapidly cool the baby down. The more the baby is cooled down by oxygen delivery, the greater the baby's oxygen demand. Thus, diverting oxygen needed clinically to produce heat will put the baby in danger.

(7) Adjust the flow rate and temperature of the humidification bottle in time and pay attention to whether the catheter is unobstructed.

(8) Excessive oxygen administration may cause hyperoxia. ① Toxicity to the lungs, seen when oxygen is given through positive pressure breathing, can cause damage to lung function and lung parenchyma, inhibit intracellular metabolism, the synthesis of deoxyribonucleic acid and ATP, and inactivate many enzymes; ② Damage to the eyes, seen in premature infants weighing less than 2000g. It mainly causes the proliferation of fibrous tissue behind the lens. Rapid changes in blood oxygen partial pressure are the most harmful. This disease can occur even if 30% to 40% oxygen is inhaled. Therefore, the appropriate oxygen concentration for premature infants should not exceed 30%; ③ The automatic ability of tracheal cilia is reduced, the mucous content of bronchial cells increases, the alveolar walls are congested and edematous, and fibrous thrombosis is formed in small blood vessels. Therefore, oxygen should be given to premature infants in a timely, accurate and cautious manner, and should be given according to the actual condition of the infant to help the infant recover as soon as possible.

What I’m going to introduce here is how premature babies should breathe oxygen correctly. I think everyone should understand it now. The care of premature babies should be comprehensive whole-body care. It is also common for premature babies to have low cognitive and communication abilities due to the immature development of their brains. Early detection and early treatment are unchanging truths.