A term newborn male presents with cyanosis and ashen appearance at 6 hours of life. Vital signs show BP 60/40 mmHg, HR 165/min, RR 48/min, SpO2 78% on room air. Echocardiography reveals severe hypoplasia of the left ventricle with retrograde aortic flow; ascending aorta measures 4 mm. Chest X-ray shows normal pulmonary vascularity. He has not received prostaglandin therapy. Which intervention is most critical to maintain systemic perfusion before surgical management?
- A)Start high dose beta blockade
- B)Administer inhaled nitric oxide only
- C)Infuse prostaglandin E1 to maintain ductal patencyGABARITO
- D)Give adenosine to slow the heart rate
- E)Administer indomethacin to close the ductus arteriosus
Explicação
Hypoplastic left heart syndrome is a ductal dependent lesion because systemic circulation depends on right ventricular output reaching the aorta through the patent ductus arteriosus. Prostaglandin E1 must be given promptly to keep the ductus open. Ductal closu... Ver explicação completa e trilha adaptativa →