NRP 9th Edition · Resuscitation
Neonatal Volume Expander
Weight-based 10 mL/kg bolus volume and infusion rate for normal saline or O-negative packed red blood cells.
Birth weight
Volume to give (10 mL/kg)
Rate by infusion time
NRP 9th Edition Protocol
- Indication
- Suspected hypovolemia — pallor, weak pulses, poor response to resuscitation
- Dose
- 10 mL/kg IV/IO
- Infusion time
- Over 5–10 minutes
- Access
- Umbilical venous catheter (UVC) or intraosseous (IO)
- Blood indicated when
- Acute blood loss (vasa previa, placental abruption, feto-maternal transfusion)
- Repeat dose
- May repeat 10 mL/kg if response is inadequate; reassess after each bolus
- Preterm caution
- GA < 32 wk: rapid or > 10 mL/kg boluses in the first day are linked to increased ICH risk
Clinical decision support only. Volume expander dosing from NRP 9th Edition (AAP/AHA). No trial has established a preferred infusion rate; a steady infusion over 5–10 minutes is reasonable in most cases. Use extra caution in infants < 32 weeks GA. PediaSuite is not affiliated with the AAP or AHA.
Reviewed by C. A. Leyva, MD, neonatologist · Last reviewed September 2026
References
- American Academy of Pediatrics, American Heart Association. Textbook of Neonatal Resuscitation. 9th ed. Itasca, IL: American Academy of Pediatrics; 2025. Lesson 7: Medications.
- Lee HC, Strand ML, Finan E, et al. Part 5: Neonatal Resuscitation: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(16 Suppl 2):S385–S423. doi:10.1161/CIR.0000000000001367
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