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ACoRN: Acute Care of at-Risk Newborns: A Resource and Learning Tool for Health Care Professionals (2 edn)

The transition chapter describes the physiological changes that occur during every newborn’s transition from intrauterine to extrauterine life. Understanding this complex and intensive process of adaptation in the human life cycle is essential for understanding ACoRN’s approach to stabilization. Transition is examined systemically—from respiratory, cardiovascular, neurobehavioural, feeding, glycemic, renal, hepatic, thermal, and immunological perspectives. Some aspects of transition occur at birth (e.g., the separation of the placenta, onset of breathing, and the switch from fetal to neonatal circulation). Cardiorespiratory, neurological, glycemic, and thermal adaptations occur within minutes, as extra-uterine life begins. Endocrine, metabolic, and immunological adaptations unfold over several hours and days. Signs and symptoms of problems during transition are discussed in ‘learning points’, along with clinical implications for stabilization. Review questions and answers are included.

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