Management of the Cyanotic Neonate with PDA Dependent Circulation

  • Assess and manage CAB ( circulation/airway/breathing)
  • Prostaglandin (PGE, Alprostadil) 0.01 µg/kg/min IV

1 vial = 1 ml = 500 µg. keep refrigerated until mixed

Mix option:

1 vial in 9 ml NS or D10W= 50µg/ml

Add 3 ml of this to 47 ml D10W in IV chamber or syringe pump = 3µg/ml

Infuse @ ml/hr equal to neonate’s wt in Kg for dose delivered at 0.05 µg/kg/min

Double rate for 0.1 µg/kg/min.

  • Consider intubation, especially before transport as prostaglandin has side effects:
    • Apnoea will require vantilation
    • Hypotension
    • Fever
    • Rash
  • If no prsotaglandin available, intubate/paralyze/anesthetize to minimize oxygen consumption.
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