Neonatal shock in the first postnatal day.

Advances in neonatal medicine have markedly reduced mortality in preterm infants. Current emphasis should be placed on early detection and treatment of neonatal hypotension and shock. Ideal clinical management includes perinatal recognition of low birth weight infants at risk for hypotension. All critically ill preterm infants should be closely monitored for tachycardia, hypotension, and/or decreased urinary output. By use of noninvasive blood pressure screening techniques, hypotensive infants may be identified in the first hours of life. Judicious use of whole blood or balanced salt solutions will result in reduction of mortality from 50% to 10%.