Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life

Kirstin Faust, Christoph Härtel, Michael Preuß, Heike Rabe, Claudia Roll, Michael Emeis, Christian Wieg, Miklos Szabo, Egbert Herting, Wolfgang Göpel

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Abstract

Objective: To evaluate lowest mean arterial blood pressure during the first 24 h of life (minMAP24) in verylowbirthweight (VLBW) infants and to identify associations between hypotension and short-term outcome. Design: Retrospective cohort analysis of the minMAP24 of 4907 VLBW infants with a gestational age <32 weeks in correlation with clinical data. Hypotension was defined as minMAP24 being lower than the median value of all patients of the same gestational age. Results: MinMAP24 values correlated with gestational age. Median minMAP24 values of VLBW infants ≤29 weeks' gestation were 1.2 mm Hg lower than gestational age in completed weeks. Hypotensive infants had a higher rate of intraventricular haemorrhage (IVH, 20.3% vs 15.9%, p<0.001), bronchopulmonary dysplasia (BPD, 19.2% vs 15.1%, p<0.001) and death (5.2% vs 3.0%, p<0.001). Multivariate logistic regression analyses, including potential confounders, confirmed these data. MinMAP24 was an independent risk factor for IVH (OR 0.97/mm Hg, 95% CI 0.96 to 0.99, p=0.003), BPD (OR 0.96/mm Hg, 95% CI 0.94 to 0.98, p<0.001) and mortality (OR 0.94/mm Hg, 95% CI 0.90 to 0.98, p=0.003). Conclusions: Hypotension during the first 24 h of life is associated with adverse outcomes in VLBW infants. This underlines the need for randomised controlled trials on the use of vasoactive drugs in this vulnerable patient cohort.

Original languageEnglish
Pages (from-to)F388-F392
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Volume100
Issue number5
DOIs
Publication statusPublished - Jul 21 2015

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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