Document Detail

Effect of Antihypotensive Treatment on Cerebral Oxygenation of Preterm Infants Without PDA.
MedLine Citation:
PMID:  22065269     Owner:  NLM     Status:  Publisher    
Background:Preterm infants with hypotension (mean arterial blood pressure [MABP] < gestational age [GA]) are treated with volume expansion and/or dopamine to ensure adequate cerebral perfusion/oxygenation. We used near-infrared spectroscopy to analyze the effects of volume expansion and dopamine on cerebral oxygenation in hypotensive preterm infants without patent ductus arteriosus (PDA).Patients and Methods:Among 390 infants, 71 (GA < 32 weeks) were hypotensive and eligible for inclusion. Thirty-three infants received volume expansion only (NaCl 0.9%; 20 mL/kg), and 38 received additional dopamine (5 μg/kg per minute). Nine and 11 infants initially treated with dopamine subsequently needed 7.5 and 10 μg/kg per minute, respectively. Seventy-one infants without hypotension were individually matched to serve as controls. MABP, regional cerebral oxygen saturation (rSco(2)), fractional tissue oxygen extraction (cFTOE), and arterial saturation (Sao(2)) were monitored 15 minutes before and 30 and 60 minutes after volume or dopamine and at comparable postnatal ages in controls.Results:No changes in MABP, rSco(2), or cFTOE were found 30 minutes after volume expansion. MABP increased 60 minutes after 5 μg/kg per minute dopamine (median [range]: 28 [19-32] vs 33 [23-46] mm Hg; P < .001). There was a small increase and decrease, respectively, in rSco(2) (63 [43-84] vs 66 [46-87]%; P < .05) and cFTOE (0.33 [0.14-0.56] vs 0.31 [0.07-0.54]1/1; P < .05). However, no differences were found at any time point between controls and infants treated with volume or additional dopamine (5, 7.5, and 10 μg/kg per minute) for rSco(2) or cFTOE.Conclusions:Volume expansion and additional dopamine do not cause any significant change in rSco(2) or cFTOE in hypotensive preterm infants without PDA. We speculate that very preterm infants with hypotension but without signs of a compromised cerebral oxygenation and systemic perfusion might not be in need of antihypotensive therapy.
Hilde J C Bonestroo; Petra M A Lemmers; Wim Baerts; Frank van Bel
Related Documents :
14747019 - Malaria immunity in infants: a special case of a general phenomenon?
18077639 - Early infant human immunodeficiency virus type 1 detection suitable for resource-limite...
3312269 - Perinatal transmission of hepatitis b virus in high-incidence countries.
24113879 - First hour initiation of breastfeeding and exclusive breastfeeding at six weeks: preval...
24411489 - Infant formula composition affects energetic efficiency for growth: the bemim study, a ...
11728649 - Sero-prevalence and mother-to-infant transmission of hepatitis e virus among pregnant w...
10796349 - Multicomponent fortified human milk for promoting growth in preterm infants.
11511979 - Acute peritoneal dialysis as both cause and treatment of hypernatremia in an infant.
11732769 - Study of a group of extremely preterm infants (25-27 weeks): how do they function at 1 ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-7
Journal Detail:
Title:  Pediatrics     Volume:  -     ISSN:  1098-4275     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, Netherlands.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Cobalamin F Disease Detected by Newborn Screening and Follow-up on a 14-Year-Old Patient.
Next Document:  Recent Advances in Management and Treatment of Hereditary Angioedema.