Initial resuscitation follows general principles. Hypoxaemia kills so don’t be afraid to use oxygen in the initial resuscitation.
Aim for a mean arterial pressure of 40 in the term neonate. If no response or patient worsening with fluid resuscitation, start peripheral inotropes.
Duct dependent congenital cardiac disease usually presents in the first two weeks of life when the duct closes but it is worth starting a prostaglandin infusion up until 1 month of age.
Start with a high dose prostaglandin infusion to open the duct (50-100ng/kg/min).
Always give antibiotics and acyclovir and check an ammonia.
The definitive diagnosis can only be made after an echocardiogram.
