GuidelinesOther guideline
Management Of Asphyxia Neonatorum
Management guidelines for students, interns and registrars on a variety of routine and emergency situations in our neonatal service at Tygerberg Children’s Hospital. Published in 2014.
- Saturation:
- Maintain SaO2 92-95% in term baby
- Maintain SaO2 88-92% in preterm baby
- Capillary filling time:
- If longer than 3 seconds, consider stabilised human serum or 0.9% physiological NaCl solution (Saline)
- Blood pressure:
- Maintain systolic blood pressure at 55-65 mmHg
- Hypotensive - consider Dopamien 5-20µg/ Kg/min
- Urine output:
- Monitor output. If urine <1 ml/Kg/hour over 6 hours, restrict fluid, give Lasix(R) 1-2 mg/ Kg/IV every 6 hrs prn
- Investigations:
- Electrolytes, acid-base status, glucose, calcium and magnesium, CK.
- Cranial ultrasound / EEG as indicated
- Intravenous fluid:
- Use K+-free fluid e.g. 5-10% D/W in 0.2% NaCl solution
- or K+-free Neonatalyte. Restrict fluid.
- Convulsions:
- Phenobarbitone, Epanutin, Lorazepam, etc
- Metabolic acidosis:
- Correct if necessary
- Clotting diathesis:
- Manage as indicated
- Persistent pulmonary hypertension:
- Oxygenate and correct acidosis