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.