RESUSCITATION OF PRETERM INFANTS WITH EARLY POSTNATAL CARDIOVASCULAR SHOCK
Autor: | Charles L Paxson, Peggy J Rapoport, Yoahio Miyazaki, David Lloyd Bolam, G C Rosenquist |
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Rok vydání: | 1977 |
Předmět: | |
Zdroj: | Pediatric Research. 11:539-539 |
ISSN: | 1530-0447 0031-3998 |
DOI: | 10.1203/00006450-197704000-01017 |
Popis: | This study was designed to evaluate the vascular compartment of infants born in the presence of maternal vaginal bleeding, and to describe one regimen for fluid and pharmacologic resuscitation. Eleven infants born to mothers with abruptio placentae exhibiting tachycardia (HR>150) and hypotension at 1 hr. age received empiric infusions of 20 ml/kg lactated Ringers solution (LR) and 20 ml/kg fresh blood. Blood volume (BV) determinations using the 51Cr RBC dilution technique were completed and BV deficits were then corrected by rapid transfusions of fresh blood. BV determinations were repeated and infants were given 1 μg/kg per min. continuous infusion of Dopamine if BV was normal and hypotension persisted. Eleven infants were studied and BV were markedly deficient as reflected in the mean red cell volume of 35 ml/kg (nl = 64), and mean total BV of 67 ml/kg (nl = 108). Two infants were infected (Group B strep, E. coli), and 2 infants remained hypotensive following BV restoration with a second transfusion. The infant with Strep infection and 1 infant given Dopamine expired. We conclude that preterm infants with hypotension resulting from abruptio placentae are markedly volume deficient and that proper management of these babies required BV determinations. Although early resuscitation with LR is efficacious (survival = 82%), treatment with Dopamine requires further evaluation. |
Databáze: | OpenAIRE |
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