Hypotension in preterm infants.
Indian Pediatr
;
2008 Apr; 45(4): 285-94
Article
in English
| IMSEAR
| ID: sea-9826
ABSTRACT
PURPOSE:
Hypotension is a frequent occurrence in sick preterm neonates. It is important to appropriately recognise and treat hypotension in preterm infants due to the possible association with short and long term adverse outcomes. SEARCH STRATEGY An extensive search for relevant articles was carried out on PubMed, Embase and Cochrane database of systematic reviews. Cross references were hand searched.CONCLUSIONS:
The pathophysiology hypotension in preterm infants is multifactorial. Hypovolemia plays only a minor role in the absence of overt fluid losses. Cardiac dysfunction seems to be a factor in some neonates. Assessment of hypotension should be based on an overall clinical condition. Overzealous fluid administration seems to be associated with adverse outcomes and should be avoided in the absence of obvious fluid losses. Inotropes should be used if fluid boluses fail to correct hypotension. Dopamine is the most effective inotrope. Dobutamine can be used as add on therapy or as first line if cardiac dysfunction is an obvious cause. Evidence points to hypocortisolism in at least some hypotensive infants. Steroids have been used successfully in inotrope-resistant hypotension in some infants. Steroids should be used judiciously since there have been concerns about adverse neurological outcome in preterm infants who received steroids in the neonatal period.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Sympathomimetics
/
Time Factors
/
Blood Pressure
/
Humans
/
Infant, Newborn
/
Infant, Premature
/
Cardiac Output
/
Cardiotonic Agents
/
Dopamine
/
Risk Factors
Type of study:
Etiology study
/
Risk factors
Country/Region as subject:
Europa
Language:
English
Journal:
Indian Pediatr
Year:
2008
Type:
Article
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