Describe what is Circulatory Support and Inotropes ?

Colloid or Crystalloids: Hypotension after PGEl infusion is common. It is the result of relative intravascular volume depletion because of a combination of peripheral vasodilation and increased vascular permeability. It is best treated by administration of 10-20 ml/kg of a colloid solution (5 per cent albumin or plasma) as a bolus. If colloid solutions are unavailable, c~ystalloids olutions may be used in the same volume. Inotsopes are likely to be ineffective unless adequate volume replacement is done.

Dopamine: This should only be administered via a central line. Doses range from 5-15 mcg/kg. This is often the first choice in most centres. It has vasoconstrictor as well as inotropic effects and is often the only agent necessary

Dobutamine: Perhaps he only reason to use dobutamine during initial resuscitation is that it done not require a central access. It has a potent inotropic effect and some vasodilatory effects. For this reason it is not as effective as Dopamine in hypotension, particularly if the myocardial contractility is normal.

Adrenaline: It has powerful vasoconstrictor and inotropic effects but is seldom required as an infusion prior to or during transportation unless the neonate sustains severe hypotension or a cardiac ail-est. Central access is a must and doses range from 0.01 -0.2 mcg/kg/mm.

Isoproterenol: Newborns with congenital complete heart block can be born with severe bradycardia and infusions of isoproterenol (0.01-0.05 mcg/kg/min) may be initiated prior to transport to center with facilities for pacemaker implantation.