Management of HI During the Neonatal Period

Admission to a NICU.
Placement in a humidified isolette at 50%–70% humidification.18
Monitoring of body temperature to prevent TEWL and associated temperature dysregulation.
Monitoring of daily body weight and fluid status; daily monitoring of electrolytes to prevent hypernatremic dehydration during the first week and thereafter based on patient’s condition.
Meeting high caloric demands and nutrition supplementation.
Skin care with daily bathing (± antiseptics) followed by application of bland emollient every 4–6 h.
Vigilant monitoring for respiratory compromise with a low threshold for intubation.
Vigilant monitoring for infection with surveillance cultures from selected skin sites and folds with a low threshold for antibiotics based on cultured microbes.
Eye care with application of bland lubricant every 6–12 h; reserve topical antibiotics for conjunctivitis or corneal abscesses.
Monitoring of limb and digit perfusion. Consider surgical intervention, splinting, and physical therapy as needed.
Controlling pain with acetaminophen, nonsteroidal antiinflammatory agents and/or narcotics as needed.