hi we have 36 weeks neoborn deleverd by SVD with dusky color and poor perepheral perfusion blood gas normal x ray chest unremarkable we connect to mecanical vent . ECHO .done show right to lt. shunt after 2 h. develop hypotension and acidosis oxygen sat. fluctuating 80 -85 / inspite nitric oxide 30 ppm and correction of acidosis and hypotension. what we can do ? dr ahmed ,,,neonatologest.
Hello and welcome to Chat Doctor, The clinical features of poor peripheral perfusion, hypotension and acidosis suggests that the shunt in heart is preventing the blood to be pumped from heart to peripheral tissues. The structural abnormality in heart is probably causing obstruction to flow of blood in aorta, the major blood vessel which supplies blood to periphery. There is probably mixing of arterial and venous blood in heart thus oxygen saturation is also very low. The oxygen saturation needs to be maintained with external oxygen. This will correct the acidosis also. The definitive treatment is surgical correction of the shunt. I suggest you to consult a pediatric surgeon for surgical correction of the defect. Thanks and take care Chat Doctor. 