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1. NEONATAL SHOCK and HYPOTENSION Steven M. Donn, M.D. Professor of Pediatrics Director, Neonatal-Perinatal Medicine C.S. Mott Children’s Hospital University of Michigan Health System
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7. Stroke Volume To increase cardiac output Increase stroke volume or Increase heart rate or Increase both
13. Effects of changes in afterload on Frank-Starling curves. A shift from A to B occurs with increased afterload, and from A to C with decreased afterload. 100 Stroke volume (mL) LVEDP (mmHg) 50 0 0 10 20
54. AGENTS USED TO TREAT NEONATAL SHOCK Never administer intra-arterially 0.05-1 mcg/k/g/min IV Norepinephrine Vasocative drugs Afterload reducer 1-20 mcg/kg/min IV Phentolamine Afterload reducer 0.5-8 mcg/kg/min IV Nitroprusside Never administer intra-arterially 0.05-0.5 mcg/kg/min IV Isoproterenol Afterload reducer 0.1-0.5 mg/kg IV q3-6h Hydralazine Never administer intra-arterially 0.05-1 mcg/kg/min IV Epinephrine Never administer intra-arterially 5-20 mcg/kg/min IV Dobutamine Never administer intra-arterially 5-20 mcg/kg/min IV Dopamine Use O Neg 10-20 mL/kg IV Reconstituted blood products Limited availability 10-20 mL/kg IV Whole blood products Inexpensive, available 10-20 mL/kg/ IV Isotonic glucose Inexpensive, available 10-20 mL/kg IV Lactated Ringer solution Expensive 10-20 mL/kg IV Plasma Expensive 10-20 mL/kg IV Albumin (5%) Inexpensive, available 10-20 mL/kg IV Isotonic sodium Volume expanders Comments Dosage Agent Agent Type
![SHOCK ,[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)