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Neonates with significant asphyxia during the perinatal period have umbilical artery pH less than 7 and Apgar scores of 0 to 3 at 5 minutes. The mechanisms of asphyxia after the immediate postpartum period are severe respiratory disease or cardiac arrest. The diagnosis of coma due to asphyxia can not be established if the mechanism for asphyxia can not be determined. The current treatment for coma due to asphyxia is supportive. More about ...110

HYPERTENSION

Coma due to hypertensive encephalopathy in neonates usually occurs when systolic blood pressure is greater than 106 mm Hg. Treatment of hypertensive encephalopathy consists of hydralazine 1 mg/kg per dose, followed by diazoxide 2 mg/kg and nitroprusside 0.25 to 0.5 mg/kg per minute if necessary. The etiology of the hypertension should be determined and corrected if possible.

HYPOGLYCEMIA

Coma due to hypoglycemia is diagnosed if serum glucose is below 40 mg/dL. Patients with hypoglycemic coma present with hypotonia, jitteriness, and respiratory difficulties prior to becoming comatose. The mechanism causing hypoglycemia should be elicited. Possible mechanisms include hyperinsulinism, endocrine deficiencies, and inborn errors of metabolism. Treatment consists of correcting hypoglycemia and eliminating its causes. More about ...40, 110

POLYCYTHEMIA

Polycythemia may produce coma. Neonatal polycythemia is defined as central venous hematocrit greater than 65%. Polycythemic neonates look plethoric and have signs of respiratory distress and congestive heart failure. Treatment consists of partial exchange transfusion.

 

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Rasoulpour, 1992 Brown, 1993