Perinatal Asphyxia(PNA)

Perinatal Asphyxia(PNA):

Clinical Features:

• 1)H/O Delayed Craying (stage-HIE-1)
• 2) H/O Convulsion (stage-HIE-2)
• 3)above complain with baby lethergic /comatose/absent of premitive reflexes (stage-HIE-3)

Rx(Admission):

(HIE stage-1)

• Diet-NPO
  
• NOP Suction stat & sos
  
• 02 inhalation stat & sos
  
• Keep the baby warm
  
• Apply Hexicord (7.1% chlorohexidine) around umbilicus stat

1. inj.K-one MM

if Day-1

2. Inf.Dextropac-10 (according to wt-not less then 100ml )

• I/V ...microdrop/min
  

3. inj.ampicillin/Ampexin(250mg/2.5ml)

• (wt/2 ) ml I/V stat & BD

4. inj.Ceftazidime/cefazid(250mg/1 vial )

• wt/2 ml I/V stat & BD

NOTE: 2nd /3rd line Drug may be used according to condition.

(HIE stage-2/convulsion)

☑️above treatment with

5. Inj.Barbit (200mg/1ml+9ml D/W) (shortcut formula)

LD(loading dose-20mg/kg)

• wt × 1ml I/V stat Then

MD(maintainance dose- 2.5 mg/kg/day)

• (wt /8) ml I/V ….12hrly

         ⬇️

if again convulsion then give

Inj.Barbit (200mg/1ml+9ml D/W)

1st half LD (loading-10mg/kg/dose)

• (wt/2) ml I/V….stat

                  ⬇️

if again convulsion then give

Inj.Barbit (200mg/1ml+9ml D/W)

2nd half LD (10mg/kg/dose)

• wt/2 ml I/V….stat

                 ⬇️

if no control of convulsion with Barbit

then give 

Inj.Fosfen(150mg/2ml+8 ml N/S)

LD(Loading Dose-30mg/kg/dose)

• wt × 2 ml I/V stat Then 

MD(Maintanance dose-5mg/kg/day)

• wt/4 ml I/V ...BD

if not controlled then 

Inj.Midazolam (5mg/5ml)

• 0.01-2 mg/kg/hour- drip 

(if HIE stage-3)

Then Change antibiotic 

Inj.Kacin(amikacin)(100mg/2ml) (15mg/kg/day)

• (0.15 ml /kg ) I/V stat & BD

inj.Meropenam(500mg/10ml)

• 30mg/kg/dose ...8 hrly

Discharge of PNA:

1. Loracef (cefaclor)pediatric drop(125mg/1.25ml)

• 5-6 drops….TDS…..7days

2. Syrp.Barbit (phenobarbitone) 

• ¾ tsf ….BD…...15 days Then
• ½ tsf ...OD …..15 days

Advice: 

• Follow-up regularly in child development centre