Respiratory distress may have multiple aetiology including acidosis, meconium aspiration, sepsis or persistent pulmonary hypertension. Avoid hypoxia and hypocarbia . Cardiac status - blood pressure is a poor predictor of low cardiac output. Cardiac ECHO may identify hypovolaemia or poor myocardial contractility and low flow states - see hypotension. Feed intolerance is common and NEC may complicate perinatal asphyxia.
Breast milk is preferred.
There is evidence from animal models that allopurinol may be additive to cerebral cooling as a neuroprotectant 17 . No randomised trial has been performed in neonates. Trials comparing MgSO 4 to placebo are required before it can be recommended. Report of the Health Care Committee Expert panel on Perinatal Morbidity. National Health and Medical Research Council.