You are called to an emergent cesarean section of a full ter…
You are called to an emergent cesarean section of a full term neonate due to non-reassuring fetal heart rate tracings. Mother was noted to have a uterine rupture. Apgars were 0 at 1 minute of life, 3 at 5 minutes of life, and 4 at 10 minutes of life. The neonate required a full resuscitation following birth including intubation/ventilation, chest compressions, two 10 ml/kg normal saline boluses, and several doses of epinephrine. The neonate has an abnormal neurological exam compatible with severe hypoxic ischemic encephalopathy and has been having seizures. At 24 hours of age, the Na+ level is 128, the creatinine is 1.6, and the urine output is 0.5 ml/kg/hr. Which of the following actions are appropriate?
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