collapsed neonate
Causes: THE MISFITS
- Trauma/non-accidental injury
- Heart disease
- Duct dependent lesion: cyanosis not responding to oxygen, abnormal pulses
- Measure pre- and post-ductal sats
- Give prostaglandin to keep the duct open!
- NSAIDs close the duct
- Electrolyte disturbance
- Metabolic disturbances - measure glucose
- Inborn errors of metabolism
- Neonatal sepsis
- Formula mistakes
- Intestinal catastrophes: malrotation+volvulus, or Necrotising enterocolitis → bilious vomiting
- Toxins: maternal drug ingestion
- Seizures/CNS
Immediate investigations
- blood gas (glucose, lactate)
- U+E
- clotting, FBC
- CXR
- ECG if HR >220
- septic screen: blood/urine culture, LP