Further studies are warranted to investigate the indications, timing and role of volume replacement in neonatal resuscitation. Volume replacement should be reserved for neonates with evidence of hypovolemia or blood loss, and crystalloids or fresh blood are preferred over albumin. (2022) is a narrative review of the causes and consequences of acute fetal blood loss and available evidence on volume replacement during resuscitation of asphyxiated neonates. However, excess volume load in the presence of myocardial dysfunction from hypoxic-ischemic injury may precipitate pulmonary edema and intraventricular hemorrhage. Failure to recognize hypovolemia will delay volume replacement and may result in unsuccessful resuscitation due to lack of adequate cardiac preload. Fetal blood loss (e.g., feto-maternal hemorrhage) may contribute to perinatal asphyxia.
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