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Neonatal and Pediatric Medicine | Volume: 04
October 25-26, 2018 | Prague, Czech Republic
World Neonatology and Child Care Meeting
Mohammad Monir Hossain, Neonat Pediatr Med 2018, Volume: 04
10.4172/2572-4983-C2-005
Mohammad Monir Hossain
Dhaka Shishu (Children) Hospital,
Bangladesh
U
nderstanding the pathophysiology of neonatal shock helps to recognize
and classify shock in the early compensated phase and initiate appropriate
treatment. Hypovolemic shock in neonate is usually due to antepartum
hemorrhage, post-natal blood loss iatrogenic or secondary to disseminated
intravascular coagulation or vitamin K deficiency or excessive insensible water
loss in extreme pre-terms. Cardiogenic shock in the neonate may be caused by
myocardial ischemia due to severe intra-partum asphyxia, arrhythmias, primary
structural heart disease, and mechanical reduction of cardiac function or
venous return secondary to tension pneumothorax or diaphragmatic hernia and
disturbance of transitional circulation due to persistent pulmonary hypertension
in newborn or patent ductus arteriosus in premature infants. Distributive shock
caused by neonatal sepsis, vasodilation, myocardial depression or endothelial
injury and obstructive shock is caused from tension pneumothorax or cardiac
tamponade. The immediate aim of management of neonatal shock is to optimize
perfusion and delivery of oxygen and nutrients to the tissues. The American
College of Critical Care Medicine estimates that 60 minutes is the average time
needed to provide adequate circulatory support and block the development of
Cause specific management of shock in neonate
shock. The first step in managing shock in the newborn during the first 5 minutes is to recognize cyanosis, respiratory distress
and decreased perfusion. This should be followed immediately by airway access and ventilation to optimize oxygenation. Rapid
peripheral, central venous or intraosseous accesses are of primary importance in the initial management of the newborn in
shock. Any baby with shock and hepatomegaly, cyanosis or a pressure gap between upper and lower limbs should be treated
with prostaglandin within 10 min of birth until congenital heart disease is excluded. Inotropes like dopamine, dobutamine,
epinephrine and norepinephrine are indicated via IV or IO route before central access is achieved when myocardial contractility
remains poor despite of adequate volume replacement. Delay increases mortality 20-fold.
Biography
Mohammad Monir Hossain is currently working as Professor of Neonatal Medicine, NICU & Critical Care of Pediatrics at the Bangladesh Institute of Child Health
(BICH) & Dhaka Shishu (Children) Hospital. He received his PhD from the University of Dhaka for his research work on Neonate Receiving Intensive Care in 2006.
After his Graduation (MBBS) in 1987, he completed Doctor of Medicine in Pediatrics (MD) in 1997. He became a Fellow of Bangladesh College of Physicians &
Surgeons (FCPS) in 1999 and Royal College of Physicians and Surgeons of Glasgow (FRCP Glasg) in 2009, Royal College of Physicians of Edinburgh (FRCP
Edin) in the same year and Royal College of Pediatrics & Child Health (FRCPCH), UK in 2010. Since 2001, he has been serving as Assistant Professor, Associate
Professor and Professor at Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital. He has authored several publications in various journals and
books. His publications reflect his research interests in Critical Care in Neonatology. He was the Executive Editor of Bangladesh Journal of Child Health (BJCH)
mhossaindr@gmail.com