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Hi. My Son Was Born Last Week When He Was

Posted on Thu, 19 Sep 2019

Question: Hi. My son was born last week when he was 35 weeks old. His lungs were not developed yet. So oxygen was provided while his oxygen levels become normal. Later doctors removed the oxygen device. A day after all the blood tension drop down. Carbon dioxide levels increased. They re inserted oxygen machine. However baby is not recovering. Doctors says there's multi organ failure. Recent analysis shows that the baby was born with Staphylococcus epidermidis that he caught in mother's womb. I think it's sepsis. But doctor's say it's something else. What do you suggest. What should we do?

Answered by Dr. Diptanshu Das (1 hour later)

Brief Answer:
Management is supportive

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through your query and understand your concerns. Your child has been born preterm and therefore the lung maturity is inadequate. This has led to a condition called Respiratory Distress Syndrome (RDS) which might need nasal CPAP (continuous positive airway pressure) which you term as oxygen machine. If the condition worsens, and if the carbon dioxide retention continues the child might need ventilation.

Along with the above condition the child possibly has sepsis (or rather septicemia since the blood culture shows growth of organisms) as a complicating factor. The CRP (C reactive protein) level as well as other blood parameters including electrolytes and creatinine need to be checked. Antibiotics need to be given suitably and the response monitored by the CRP levels. Management is largely supportive and symptomatic.

Discuss the condition with the treating doctor and they would be able to provide you with the necessary updates about how they are handling the situation and what they are planning to do. You need to be patient and calm. Let us hope that things gradually improve.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Diptanshu Das (59 minutes later)

The baby's hands feet nose is blue. Is it sign of sepsis?

Right now major problem is urination. He haven't urinated for a while. Doctors are providing medicine. But do you have a suggestion ? If he doesn't urniate things will be very risky

Answered by Dr. Diptanshu Das (10 minutes later)

Brief Answer:
Circulatory collapse

Detailed Answer:
The fact that periphery is blue and urine volume is little or none indicates a state of circulatory collapse or shock. It is a serious condition. Volume resuscitation (IV fluids) would be the first step and if that doesn't help, inotropes like dopamine and/or dobutamine need to be infused.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Diptanshu Das (6 hours later)

Dopamin and IV fluids have already been infused. But there's no urination. What else can be done?

Answered by Dr. Diptanshu Das (1 hour later)

Brief Answer:
Dobutamine

Detailed Answer:
Dobutamine perhaps needs to be started. It is hard to comment without having the specific clinical parameters at hand.

Regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj