A 6 day old baby presents pale and lethargic. HR 200, BP undetectable, O2 saturation 90%, RR: 40, finger stick 20. You give dextrose but symptoms do not improve. You suspect congenital heart disease and confirm this with a hyperoxia test. You then administer an intervention but the baby subsequently becomes apneic. The patient is intubated, vitals improve, and you call pediatric cardiology. What is the hyperoxia test? What intervention was given?
Answer: Hyperoxia test: Administer 100% O2 for 10 mins, if the paO2 (can measure pulseox) remains the same, likely cardiac pathology. PGE1 was administered, with apnea as the most serious side effect.
Bonus: Dosing of dextrose, D10 5-10 ml/kg (neonates), D25 2-4 ml/kg, D50 1-2 ml/kg. (An easy way to remember it from PEM Fellow Inna: The (concentration)*(volume) = 100).