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

journal contribution
posted on 2023-06-08, 20:24 authored by K Faust, C Härtel, M Preuß, Heike RabeHeike Rabe, C Roll, M Emeis, C Wieg, M Szabo, E Herting, W Göpel, German Neonatal Network, NeoCirculation Project
Objective To evaluate lowest mean arterial blood pressure during the first 24 h of life (minMAP24) in very-low-birthweight (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.

History

Publication status

  • Published

Journal

Archives of Disease in Childhood

ISSN

0003-9888

Publisher

BMJ Publishing Group

Issue

5

Volume

100

Article number

F388-F392

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2015-03-23

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