Jednou z nejtragičtějších událostí, která může novopečené rodiče potkat, je ta, když jejich zdravé miminko plné života z ničeho nic přestane dýchat a jeho srdíčko se zastaví. V takovém okamžiku rozhodují vteřiny. Pokud se kojenci včas nedostane rychlé pomoci, už se neprobudí. Víte, jak syndromu náhlého úmrtí předcházet a jak poskytnout první pomoc?
Co je syndrom náhlého úmrtí novorozence?
Syndrom náhlého úmrtí dítěte (SIDS – Sudden Infant Death Syndrom) označuje náhlou smrt miminka v prvním roce života bez zjevné příčiny. Znamená to, že k ní dochází bez jakýchkoli známek zdravotních obtíží, tudíž ho ani nelze klasifikovat jako nemoc.
SIDS bohužel patří mezi hlavní příčiny úmrtí kojenců ve vyspělých zemích, přičemž v České republice ročně postihne několik desítek dětí. Pokud by vás zajímalo, jaká je u syndromu náhlého úmrtí statistika, je to přibližně 1 dítě z 2000. K této smutné události dochází ve spánku, kdy miminko jednoduše přestane dýchat a jeho srdce se zastaví. A pokud neprodleně nedostane rychlou pomoc, už se neprobudí. [1]
Do kdy hrozí syndrom náhlého úmrtí kojence?
Největší riziko syndromu náhlého úmrtí hrozí kojencům do 6. měsíce života a poté již výrazně klesá. Nejčastěji k němu však dochází mezi 2. a 4. měsícem věku, přičemž nejnebezpečnější bývá doba v noci, tedy mezi půlnocí a 6. hodinou ranní. Větší riziko dále také hrozí předčasně narozeným dětem a novorozencům s nízkou porodní váhou. [2], [3]
Jaká je příčina syndromu náhlého úmrtí kojenců?
Syndrom náhlého úmrtí bohužel nemá zjevnou příčinu a zpravidla ani pitva neodhalí přesný důvod, proč k selhání plic a zástavě srdce vůbec došlo. Existuje však mnoho studií, které se touto problematikou zabývají a podle nich existují určité faktory, které mohou přispět k nečekanému úmrtí miminka. Mezi ně patří i některé metabolické poruchy, jako:
- Porucha metabolismu glukózy
- Porucha beta oxidace mastných kyselin
- Porucha krevní srážlivosti
- Porucha iontových kanálků myokardu
Je jisté, že na vině nejsou žádné infekce či jiná onemocnění, dávení ani poruchy imunity. Může se ovšem jednat o poruchu srdečního rytmu či postižení dechového centra v prodloužené míše. Roli dále mohou hrát faktory, mezi něž patří:
- Nízká porodní hmotnost miminka
- Předčasný porod
- Přehřátí miminka v přetopené místnosti
- Spánek na měkkém povrchu a přítomnost měkkých hraček v postýlce
- Spánek na bříšku či na boku
- Miminko nebylo kojené
- Kouření matky v těhotenství [4], [5], [6]
Jaká je prevence syndromu náhlého úmrtí?
Vzhledem k tomu, že příčiny syndromu náhlého úmrtí nejsou zcela zřejmé, preventivní opatření jsou v tomto případě založena pouze na pravděpodobných příčinách, které mohou představovat rizikový faktor pro vznik SIDS.
V první řadě byste tedy miminko v prvním půl roce života neměli ukládat do postýlky na bříško ani na bok, ale výhradně na záda. V místnosti, kde spí, udržujte přiměřenou pokojovou teplotu, aby se novorozeně nemohlo přehřát, a neoblékejte ho zbytečně do mnoho vrstev. Stejně tak by nemělo být místnost ani příliš chladno. V přítomnosti miminka by dospělí neměli nikdy kouřit, zejména pak v nevětraném prostoru.
Děťátko by tedy mělo usínat na zádech v postýlce na pevné matraci, nikoli ve vaší posteli nebo na gauči a podobných měkkých materiálech. Stejně tak by dítě nemělo mít kolem sebe žádné měkké předměty. Existují rovněž domněnky, že používání dudlíku snižuje pravděpodobnost SIDS, ale prozatím to nebylo nijak prokázáno. Stejně tak se předpokládá, že u dětí kojených mateřským mlékem, existují nižší šance, že k náhlému úmrtí dojde.
Monitory dechu
Naprosto nejúčinnější prevenci SIDS představují monitory dechu, čili takové, které jsou certifikovány jako zdravotnické pomůcky. Tento přístroj dokáže detekovat dechové pohyby miminka a upozorní vás na nepravidelnosti a pauzy bez dechu.
Dojde-li tedy k zástavě dechu, spustí se alarm, díky kterému můžete poskytnout první pomoc a svého potomka zachránit. V některých případech se dokonce může miminko díky alarmu probudit a začít opět dýchat. [7], [8]
Syndrom náhlého úmrtí kojence: první pomoc
Ať už jste navštěvovali předporodní kurzy či nikoli, naučit se pravidla první pomoci novorozenci je záležitost, kterou byste rozhodně opomenout neměli. Pokud miminko přestane dýchat, je naprosto zásadní umět poskytnout resuscitaci.
Jak přesně postupovat? V první řadě dítě vezměte do náruče a zkuste jej poplácat po zadečku a po zádech. Pokud se ani tehdy nenadechne, dítě položte na pevnou podložku a ověřte, zda nemá něco v ústech. Následně mu mírně zakloňte hlavičku, prsty přizvedněte bradu a začněte provádět umělé dýchání spolu s masáží srdce. Postup je následující:
- Pokud dítě nedýchá, svými ústy překryjte jeho nos a pusu a proveďte 5 umělých vdechů. Proveďte to tak, aby se hrudník miminka viditelně zvednul.
- Následně zahajte masáž srdce špičkami dvou natažených prstů a stlačujte hrudní kost v její dolní části do hloubky jedné třetiny hrudníku ve frekvenci 100 až 120 stlačení za minutu.
- Po 30 stlačeních hrudníku uveďte hlavičku do neutrální polohy a proveďte dva umělé vdechy. Poté pokračujte ve stlačování hrudníku a umělém dýchání v tomto poměru, tedy 30 ku 2.
- Po 60 vteřinách resuscitace volejte linku 155. Dejte si telefon na hlasitý odposlech a pokračujte v resuscitaci, dokud dítě nezačne projevovat známky života. [9], [10], [11]
Zdroje: danieldrazan.cz/preventivni-pece, sidsforum.cz, stefajir.cz, nutriklub.cz, naseporodnice.cz, zdravykojenec.cz, pediatriepropraxi.cz, nadacekrizovatka.cz
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