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Bradycardia in neonates, a condition characterized by an abnormally slow heart rate, poses a critical challenge in the delicate realm of new-born healthcare. Within the first 28 days of life, infants with bradycardia exhibit heart rates lower than the age-appropriate normal range, typically falling below 100 beats per minute. This condition, often originating from various etiologies, demands vigilant clinical attention due to its potential to disrupt the intricate balance of oxygen delivery and vital organ perfusion crucial for the neonate's survival. Neonatal bradycardia can be broadly classified into central and peripheral types, each requiring distinct diagnostic and therapeutic approaches. Central bradycardia, stemming from dysfunction in the cardiac conduction system, frequently manifests as a consequence of congenital heart defects, cardiac arrhythmias, or maternal drug exposure. Peripheral bradycardia, on the other hand, may result from inadequate oxygenation, sepsis, or neurological impairment, accentuating the multifactorial nature of this condition. Timely identification of bradycardia is paramount, often relying on continuous monitoring and swift intervention. Neonatal resuscitation protocols underscore the significance of prompt and targeted interventions such as positive pressure ventilation, chest compressions, and administration of medications like epinephrine. The nuanced interplay between gestational age, birth weight, and the underlying pathology complicates the management of neonatal bradycardia, necessitating a tailored approach for each case. Long-term neurodevelopmental outcomes, contingent upon the rapid restoration of normal heart rates, add an additional layer of complexity to the management of these vulnerable patients. Collaborative efforts among neonatologists, Paediatric cardiologists, and other specialists are indispensable in navigating the intricate landscape of neonatal bradycardia, ensuring optimal outcomes for these fragile lives at the outset of their journey. As advancements in neonatal care continue to unfold, the pursuit of comprehensive understanding, vigilant surveillance, and precisely targeted interventions remains paramount in safeguarding neonates against the formidable challenge of bradycardia.
