What medication needs to be started and at what dose?
Dinoprostone (prostaglandin E2) or alprostadil (Prostin, prostaglandin E1) should be started at 50ng/kg/min in infants up to 1 month of age who present in a peri-arrest state. This reverses functional closure of the ductus arteriosus by relaxing the duct muscles and a response will be seen in fifteen minutes. The duct normally closes a few days after birth having up until now provided systemic blood flow in obstructive left heart lesions, pulmonary blood flow in right heart obstruction and improved mixing in TGA.
Making up Prostin is challenging and it is best to use your local retrieval service website drug calculator.