Nurses: Melissa
- Mr. Stein's exam (Ballard Score) is more like that of a 27-28 week-old than 25-26 weeks.
- Hypotensive with MAP 15-20. Needs dopamine to support blood pressure.
- Intubated but spontaneously breathing. Moderate to severe respiratory distress syndromes (RDS) on X-Ray. Group B Strep (GBS) pneumonia not excluded. Receives 3 doses of surfactant with improved aeration.
- Under lights for hyperbilirubinemia (Bili ~4-5). Evolving post birth ecchymoses are a likely source.
- Echocardiogram pending to evaluate PDA.
- Hematocrit 36. Will transfure to keep above 40 until extubated (anemia induces increased cardiac output and stresses the lungs) Will keep above 35 thereafter. Most of the anemia is probably iatrogenic, the consequence of necessary medical care (due to blood drawn for tests and cultures). His entire blood volume is about 80 mL.
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