A healthy term neonate is born at a community hospital to a 26-year-old primigravida after an uncomplicated vaginal delivery. The prenatal laboratory parameters are normal amd negative for syphilis, human immunodeficiency virus, hepatitis B, and group B streptococci. The birthweight is 3.5 kg and the Apgar scores are 8 and 9 at 1 minute and 5 minutes, respectively. The neonate receives a vitamin K injection at the delivery suite. After an uneventful 1 hour postdelivery, the nurse notes that the infant appears “dusky” and “blue.” His temperature is 99.1°F (37.3°C), heart rate is 130 beats/min, mean blood pressure is 45 mm Hg, respiratory rate is 36 breaths/min, and oxygen saturation is 98%. Approximately 15 minutes later, he exhibits a gasping respiratory pattern, his oxygen saturation falls to 80%, and his respiratory rate is 64 breaths/min. Endotracheal intubation for respiratory distress is accomplished successfully. The mean blood pressure begins to fall,...

You do not currently have access to this content.