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6. Lesson Drugs

6. Lesson Drugs. Course contents. Neonatal drug indications in newborn resuscitation The drugs used in resuscitating a n ewborn Routes of administration of drugs during the resuscitation of a newborn Umbilical venous catheter insertion A drenaline use

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6. Lesson Drugs

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  1. 6. Lesson Drugs

  2. Course contents • Neonatal drug indications in newbornresuscitation • The drugs used inresuscitating anewborn • Routes of administration of drugs duringtheresuscitation of a newborn • Umbilical venous catheter insertion • Adrenalineuse • The use of volume expanders duringtherescuscitation of a newborn

  3. If the heart rate, in spite of ventilation and chest compression is below 60 beats / min, be sure thatthe ventilation and compression are applied effectively . !

  4. Newborn drug delivery routes • Umbilical • Endotracheal tube • Intraosseous

  5. Umbilical vessels

  6. Performingumbilical catheterization • Cleanwith iodine • Do a flat incision justleaving 1-2 cm on thecord • Insert the catheter intothe umbilical veinthroughthe skin • Control by0.5 ml saline

  7. Place of umbilical catheter

  8. Endotracheal tube • The fastest way to apply • However, absorption is not reliable • Higher dosesshould be used ,n comparisontointravenous route

  9. Intraosseous • Limited data on itsuse in newborns • May be an alternative

  10. Adrenaline indication Effective positive pressure ventilation for 30 seconds Effectiveventilationfor 60 sec+ compression Heart rate below 60 beats / min

  11. As a result of effective ventilation and compression for a period of 60 seconds, if heart rate is below 60 beats / min adrenaline should be administeredthroughthe umbilical way . !

  12. Adrenaline • Increasesboththe rate andstrength of heart contractions • Leads to peripheral vasoconstriction • May increaseblood flow to the brain and coronary arteries

  13. Ifadrenalineis given early • Time forappropriateventilation is consumedforthedrug administration • If adrenaline is givenwithout ensuring adequate ventilation, increased oxygen demand maycausemyocardialdamage

  14. Adrenaline use

  15. Dilution of adrenaline

  16. REVISION

  17. The expected effect of adrenaline • Continue ventilation with100% oxygen and heartcompression • Heart rate increasesabove60 beats/min in 60 secs.

  18. If no improvement • Controltheefficacy of ventilationand compression • Insert endotracheal tube/check • Dose may be repeated in every 3-5 min • Iflowdose is used in beginning, increasetohighestdosesduringtherepeatdoses. • Apply repeated doses via intravenousroute, if possible

  19. ! If the baby seems to be in shock and does not respondtoresuscitation, considertogivevolume expander.

  20. Signs of shock • Paleness • Prolonged capillary filling time • Weak pulse • Low or "0" blood pressure

  21. Volume expanders • 0.9% NaCl (normal saline) • Ringer's lactate • O Rh (-) erythrocyte suspension (in case of severe fetal anemia)

  22. Volume expanders

  23. REVISION

  24. Key points

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