4.4 Post Resuscitation Care - Investigations and Imaging

Question 1

What investigations should be run post resus?

Answer 1

• BSL
• Blood gas
• FBC
• Blood MCS
• Placental pathology

Question 2

With regards to BSLs post resus what are the key practice points?

Answer 2

• Any infant who has required resuscitation is at risk of hypoglycaemia.
• Check BSL within an hour of birth.
• If BSL low (<2.6) send a true blood glucose to the laboratory.
• Aim TBG > 3.0mmol/L for all infants who have required resuscitation.

Question 3

With regards to blood gas post resus what are the key practice points?

Answer 3

• Any infant who has required prolonged PPV, intubation and/or CPR at birth will require a blood gas
• A pre-ductal (right radial) arterial blood gas is the gold standard.
• A capillary or venous sample will suffice if an arterial sample cannot be obtained.

Question 4

With regards to FBC post resus what are the key practice points?

Answer 4

• Severe anaemia may explain why a newborn infant required extensive resuscitation or was unresponsive to resuscitation interventions.
• Severe anaemia may occur secondary to a feto-maternal haemorrhage.
• An arterial or venous sample is preferable, although a capillary sample will suffice.
• A low white cell count or neutropenia may indicate severe infection

Question 5

With regards to blood MCS post resus what are the key practice points

Answer 5

• An arterial or venous sample is required for blood cultures.
• Do not delay the administration of antibiotics if unable to obtain blood cultures.
• Antibiotics should be administered within 1 hour of birth for all infants at risk of infection.

Question 6

With regards to placental pathology post resus what are the key practice points?

Answer 6

Specific circumstances in which this is required

Send chilled and unfixed

Question 7

What imaging should be run post resus?

Answer 7

CXR in specific circumstances