What is the initial intervention for an 1100 g male neonate with a heart rate of 30/min and central cyanosis?

In the scenario where an 1100 g male neonate has a heart rate of 30/min and displays central cyanosis, the priority is to ensure adequate ventilation and oxygenation. A heart rate of 30 beats per minute indicates severe bradycardia, which requires immediate intervention to restore effective circulation and respiratory function.

Initiating manual ventilation is the most critical initial intervention. In neonates, especially those who are extremely low birth weight, maintaining adequate oxygenation through assisted ventilation is essential to prevent further deterioration. By using bag-mask ventilation, healthcare providers can increase the neonate's tidal volume and help establish adequate oxygen levels in the blood, which is crucial for reversing the cyanosis and improving heart rate.

Other interventions, such as administering supplemental oxygen, might be necessary but do not address the immediate need for proper ventilation. Similarly, therapies like CPAP or mechanical ventilation are typically considered after initial manual breaths have been provided if the infant does not respond to the immediate interventions. This makes manual ventilation the most appropriate and urgent initial step in this circumstance.