Hypotension in Newborn Infants and Its Treatment
Systemic hypotension is a common complication of sick premature infants and may be associated with major adverse outcomes, including intraventricular hemorrhage, neuro-developmental morbidity, and mortality. There is no consensus among neonatologists regarding either the definition of hypotension or...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2013-08-01
|
| Series: | Güncel Pediatri |
| Subjects: | |
| Online Access: | http://www.guncelpediatri.com/eng/makale/3228/105/Full-Text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846092666029211648 |
|---|---|
| author | Fahrettin Uysal Özlem Mehtap Bostan Evren Semizel Filiz Akaltun Gülcan Üner Ergün Çil |
| author_facet | Fahrettin Uysal Özlem Mehtap Bostan Evren Semizel Filiz Akaltun Gülcan Üner Ergün Çil |
| author_sort | Fahrettin Uysal |
| collection | DOAJ |
| description | Systemic hypotension is a common complication of sick premature infants and may be associated with major adverse outcomes, including intraventricular hemorrhage, neuro-developmental morbidity, and mortality. There is no consensus among neonatologists regarding either the definition of hypotension or the lower threshold level of systemic arterial blood pressure in which neurological injury is inevitable. For this reason, there is a considerable variation in the reported prevalence of hypotension among different neonatal units. However, it is widely accepted by many of clinicians that early and aggressive treatment of hypotension in the neonates leads to improved neurologic outcome and survival. The goal of treatment of hypotension is to maintain adequate organ blood flow, particularly, cerebral blood flow. Because of difficulties in evaluating organ perfusion and adequacy of cerebral oxygen delivery, treatment decisions are based on statistically defined gestational and postnatal age-dependent normative blood-pressure values combined with clinical intuition. Current treatment of hypotension in the premature infant includes the use of volume expansions, inotropes, vasopressor agents and corticosteroids. It has been reported that dopamine, as a commonly used inotropic agents in the neonatal period, is more effective than dobutamine in the raising of blood pressure. Some hypotensive premature infants have low cortisol levels because of adrenocortical insufficiency, and corticosteroids are generally reserved for treatment of refractory hypotension of these infants; however, it is not recommended for prophylaxis or routine clinical use because of its potential serious side effects. This article aims to review some of the controversies about diagnosis and management of systemic hypotension in the newborn infants. (Journal of Current Pediatrics 2013;11:68-76) |
| format | Article |
| id | doaj-art-a27c917a08a84994bc14bc70664bc7ad |
| institution | Kabale University |
| issn | 1304-9054 |
| language | English |
| publishDate | 2013-08-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Güncel Pediatri |
| spelling | doaj-art-a27c917a08a84994bc14bc70664bc7ad2025-01-02T20:47:21ZengGalenos Publishing HouseGüncel Pediatri1304-90542013-08-01112687610.4274/Jcp.11.43153Hypotension in Newborn Infants and Its TreatmentFahrettin UysalÖzlem Mehtap BostanEvren SemizelFiliz AkaltunGülcan ÜnerErgün ÇilSystemic hypotension is a common complication of sick premature infants and may be associated with major adverse outcomes, including intraventricular hemorrhage, neuro-developmental morbidity, and mortality. There is no consensus among neonatologists regarding either the definition of hypotension or the lower threshold level of systemic arterial blood pressure in which neurological injury is inevitable. For this reason, there is a considerable variation in the reported prevalence of hypotension among different neonatal units. However, it is widely accepted by many of clinicians that early and aggressive treatment of hypotension in the neonates leads to improved neurologic outcome and survival. The goal of treatment of hypotension is to maintain adequate organ blood flow, particularly, cerebral blood flow. Because of difficulties in evaluating organ perfusion and adequacy of cerebral oxygen delivery, treatment decisions are based on statistically defined gestational and postnatal age-dependent normative blood-pressure values combined with clinical intuition. Current treatment of hypotension in the premature infant includes the use of volume expansions, inotropes, vasopressor agents and corticosteroids. It has been reported that dopamine, as a commonly used inotropic agents in the neonatal period, is more effective than dobutamine in the raising of blood pressure. Some hypotensive premature infants have low cortisol levels because of adrenocortical insufficiency, and corticosteroids are generally reserved for treatment of refractory hypotension of these infants; however, it is not recommended for prophylaxis or routine clinical use because of its potential serious side effects. This article aims to review some of the controversies about diagnosis and management of systemic hypotension in the newborn infants. (Journal of Current Pediatrics 2013;11:68-76)http://www.guncelpediatri.com/eng/makale/3228/105/Full-TextNewborn infanthypotensiontreatmentvasoconstrictor agents |
| spellingShingle | Fahrettin Uysal Özlem Mehtap Bostan Evren Semizel Filiz Akaltun Gülcan Üner Ergün Çil Hypotension in Newborn Infants and Its Treatment Güncel Pediatri Newborn infant hypotension treatment vasoconstrictor agents |
| title | Hypotension in Newborn Infants and Its Treatment |
| title_full | Hypotension in Newborn Infants and Its Treatment |
| title_fullStr | Hypotension in Newborn Infants and Its Treatment |
| title_full_unstemmed | Hypotension in Newborn Infants and Its Treatment |
| title_short | Hypotension in Newborn Infants and Its Treatment |
| title_sort | hypotension in newborn infants and its treatment |
| topic | Newborn infant hypotension treatment vasoconstrictor agents |
| url | http://www.guncelpediatri.com/eng/makale/3228/105/Full-Text |
| work_keys_str_mv | AT fahrettinuysal hypotensioninnewborninfantsanditstreatment AT ozlemmehtapbostan hypotensioninnewborninfantsanditstreatment AT evrensemizel hypotensioninnewborninfantsanditstreatment AT filizakaltun hypotensioninnewborninfantsanditstreatment AT gulcanuner hypotensioninnewborninfantsanditstreatment AT erguncil hypotensioninnewborninfantsanditstreatment |