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MANAGEMENT:

Adequate ventilation and oxygenation

Its recommended with avoidance of Hyperoxia and Hypocapnea.

Hyperoxia may cause increased O2 free radicals .

Hyperoxemia may increase cerebal blood flow4

Hypocapnia in particular may lead to severe brain hypoperfusion and cellular alkalosis and has been
associated with worse neurodevelopmental outcomes.

For Terms 100% oxygen is use when Cyanotic and Bradycardic

For Preterms 90% o2 saturation is The Target ,if bradycadic persistently ,give 100% oxygen

Anticonvulsant Therapy

Phenobarbtal is the drug of first choice to treat Neonatal Seizures, Loading Dose 20mg/Kg ,Maintainace
Dose of Phenobarbital is lower in first week of life (3.5 mg/kg/day) and increase to 5-7 mg/kg/day with
increasing postnatal Age.

Phenytoin:Second Drug of Choice ,Loading Dose of 20mg/kg intravenously and Mainatainace dose is
5mg/kg/day

Midazolam: used in Uncontolled Seizues ,Usual dose is 0.02-0.06 mg/kg per dose due to possibility of
Respiratory depression use of this with ventilator support.

Fluid Restriction

Because of the concern for acute tubular necrosis (ATN) and syndrome of inappropriate antidiuretic
hormone (SIADH) secretion, fluid restriction is typically recommended for these infants until renal
function and urine output can be evaluated.recommendation to control consequences of HIE following
perinatal asphyxia include the restriction of fluids at 40-50cc/kg/day

Avoid Hypotension,Hypertension ,Hyperviscosity and Hypogycemia