When is it indicated to administer a volume expander during resuscitation?

Administering a volume expander during neonatal resuscitation is indicated when the baby is not responding and exhibits signs of shock. This scenario often suggests that the infant may be experiencing inadequate perfusion, particularly due to blood loss or other causes of hypovolemia. In such cases, volume expanders, which may include normal saline or lactated Ringer's solution, can help restore circulating volume, improve cardiac output, and enhance perfusion to vital organs.

Signs of shock in a newborn may include slow heart rate, poor perfusion (e.g., delayed capillary refill), weak pulse, and altered consciousness or responsiveness. Prompt administration of volume expanders can be critical in these situations, as it directly addresses the underlying issue of inadequate blood volume, thereby supporting the resuscitation efforts and improving the chances of a positive outcome.

Other options suggest conditions that do not warrant the immediate administration of a volume expander. For instance, a heart rate above 100 bpm typically indicates that the neonate may not be in a distressed state, and administering a volume expander at this point could be unnecessary. Additionally, waiting until after two rounds of CPR or administering volume expanders based on provider fatigue are not guidelines supported by current resuscitation protocols and