Case of the Month #36 Collapsed Neonate

Published 23/02/2023

Key Take Home Messages

  • Initial resuscitation follows general principles. Hypoxaemia kills so don’t be afraid to use oxygen in the initial resuscitation. 

  • Aim for a mean arterial pressure of 40 in the term neonate. If no response or patient worsening with fluid resuscitation, start peripheral inotropes. 

  • Duct dependent congenital cardiac disease usually presents in the first two weeks of life when the duct closes but it is worth starting a prostaglandin infusion up until 1 month of age. 

  • Start with a high dose prostaglandin infusion to open the duct (50-100ng/kg/min).  

  • Always give antibiotics and acyclovir and check an ammonia. 

  • The definitive diagnosis can only be made after an echocardiogram.