Neonates

Question 1

What is the cord pH and base deficit in metabolic acidosis?

Answer 1

pH less than 7 and base deficit more than 12

Question 2

What are the maternal and placental causes of HIE?

Answer 2

Maternal - Inadequate placental perfusion and bp problems

Placental - Prolonged uterine contraction, ruptured uterus, placental abruption

Question 3

What can cause interruption of umbilical blood flow?

Answer 3

Cord prolapse and shoulder dystocia

Question 4

Features of mild HIE?

Answer 4

Irritable baby, excessive response to stimulation, staring of eyes, hyperventilation, hyperrefelxia

Question 5

Management of mild HIE?

Answer 5

Resuscitate, ABC, PaCO2, dobutamine for BP, fluids

Question 6

What fluids would you give?

Answer 6

60-80% maintainence (40ml/kg in the first 24 hours)

Question 7

What PaCO2 would you maintain?

Answer 7

4.5-6kPa

Question 8

Features of mild HIE?

Answer 8

Hypotonic, seizures

Question 9

Management of HIE?

Answer 9

Anticonvulsants for seizures, maintain normoglycaemia, treat hypocalcaemia, give IM Phytomenadione, withhold feeding for 48 hours to avoid NEC

Question 10

Features of severe HIE?

Answer 10

No spontaneous movement, tone may alternate from hypo to hyper, non treatable seizures, multi organ failure.

Question 11

Additional management for severe HIE?