Final answer:
Infants with cardiovascular issues during resuscitation are assessed using the Apgar score, focusing on heart rate and respiration. A score below 7 indicates the need for medical aid, while below 5 is critical. Treatment may involve intubation, CPAP, pulmonary surfactant and may extend to CPR if necessary.
Step-by-step explanation:
Management considerations for infants with cardiovascular abnormalities during resuscitation must take into account several critical factors. The Apgar score, introduced by Dr. Virginia Apgar in 1952, is pivotal in assessing a newborn's need for medical intervention, specifically looking at heart rate and respiration. Infants scoring below 7 at 5 minutes may require immediate medical assistance, and those with a score below 5 are in an emergency situation. Neonates with heart rate issues may have experienced oxygen deprivation during birth, potentially necessitating emergency delivery methods.
The transition from fetal to postnatal life involves significant circulatory changes as fetal hemoglobin, efficient in binding oxygen at low pressures, gives way to adult hemoglobin and the lungs begin to function. Infants born prematurely or with low birth weight due to intrauterine growth restriction (IUGR), often related to placental insufficiency, face high risks and require intensive medical care.
Treatment for infants not breathing independently at delivery may involve resuscitation, intubation, and mechanical ventilation. Infants capable of spontaneous breathing might still need CPAP (continuous positive airway pressure) and potentially, administration of pulmonary surfactant—a treatment which has halved RDS-related mortality rates. Adjunct therapies may include corticosteroids, oxygen supplementation, temperature regulation, nutritional support, and antibiotics for premature infants.