Post-resuscitation management of asphyxiated neonates.
Inspite of major advances in monitoring technology and knowledge of fetal and perinatal medicine, perinatal asphyxia is one of the significant causes of mortality and long term morbidity. Data from National Neonatal Perinatal Database suggests that perinatal asphyxia contributes to almost 20% of neonatal deaths in India. "Failure to initiate or sustain respiration after birth" has been defined as criteria for the diagnosis of asphyxia by WHO. Perinatal asphyxia results in hypoxic injury to various organs including kidneys, lungs and liver but the most serious effects are seen on the central nervous system. Levene's classification is a useful clinical tool for grading the severity of hypoxic ischemic encephalopathy. Good supportive care is essential in the first 48 hours after asphyxia to prevent ongoing brain injury in the penumbra region. Strict monitoring and prompt correction is needed for common problems including temperature maintenance, blood sugars, blood pressure and oxygenation. Phenobarbitone is the drug of choice for the treatment of convulsions.
Agarwal
Ramesh
R
Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Jain
Ashish
A
Deorari
Ashok K
AK
Paul
Vinod K
VK
D000927:Anticonvulsants / Q000627:therapeutic use; D001238:Asphyxia Neonatorum / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002118:Calcium / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004280:Dobutamine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D005440:Fluid Therapy; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000145:classification / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D007186:Incubators, Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000008:administration & dosage; D010634:Phenobarbital / Q000627:therapeutic use; D012121:Respiration, Artificial; D016896:Treatment Outcome
D000927:Anticonvulsants; D002316:Cardiotonic Agents; D004280:Dobutamine; D010100:Oxygen; D002118:Calcium; D010634:Phenobarbital