Infant Data
Results
INDICATIONS
Resuscitation: Volume expanders should be considered in neonates with clinically apparent hypovolemia, but should not be used in the absence of evidence of acute blood loss. Normal saline (sodium chloride 0.9%) is the preferred isotonic crystalloid solution, and Lactated Ringer’s is an acceptable alternative. In babies with severe fetal anemia, O Rh-negative packed red blood cells should be considered as part of volume expansion. The American Heart Association (AHA) did not review the use of volume expanders in the 2015 Neonatal Resuscitation guidelines; therefore, the 2011 AHA guideline still applies.
CONTRAINDICATIONS/PRECAUTIONS
Large fluid volumes can decrease cardiac output in hypoxic infants. Avoid rapid administration of volume expanders due to the risk for intracranial hemorrhage. Rapid administration of packed red blood cells may precipitate heart failure.
ADMINISTRATION
For resuscitation (volume expansion), give normal saline over 5 to 10 minutes. Consider a longer duration of administration in preterm neonates less than 30 weeks GA.
MONITORING
Monitor heart rate, blood pressure.