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.