Neonatal resuscitation: Difference between revisions

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#*IV dextrose at 1.5 maintenance
#*IV dextrose at 1.5 maintenance
#*Dialysis if ammonia >500
#*Dialysis if ammonia >500
==References==
<references/>


==See Also==
==See Also==

Revision as of 17:37, 10 September 2015

Use this note for the non-delivery related resuscitation of the newborn; see newborn resuscitation for immediate after-delivery resuscitation.

Background

Diagnosis

  1. Neonate in shock
  2. Neonate <1mo age

Work-Up

  1. Blood glucose (stat)
  2. Sepsis workup
  3. ECG
  4. Ammonia to rule in Inborn Errors^
    1. Need to look up values for neonate. Ammonia is high as liver is immature (i.e. that's why neonates are jaundice)

If hypoxic or evidence of CHF assume CHD

  • CHF in neonate = hepatomegaly, wheezing, gallop
  • if unclear do Hyperoxia test
    • place infant on 100% O2 for 10 minutes
    • check ABG, if O2<100 torr, highly predictive of CHD
    • some use Pulse Ox <95%, less sensitive
  • Abdominal xrays may help rule in intestinal disaster early

Differential Diagnosis

Sick Neonate

THE MISFITS [1]

Treatment

  1. Full sepsis work-up
  2. Pressors if CHD suspected
  3. Intubate and give PGE
    • Sides effects of PGE include apnea (10%)
  4. If inborn errors suspected
    • IV dextrose at 1.5 maintenance
    • Dialysis if ammonia >500

References

  1. Brousseau T, Sharieff GQ. Newborn emergencies: the first 30 days of life. Pediatr Clin North Am. 2006 Feb;53(1):69-84, vi.

See Also