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Inotropes for preterm babies during the transition period after birth: friend or foe?
  1. Heike Rabe1,2,
  2. Hector Rojas-Anaya2
  1. 1Department of Paediatrics, Brighton and Sussex Medical School, Brighton, UK
  2. 2Department of Neonatology, Brighton Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Heike Rabe, Academic Department of Paediatrics, Brighton and Sussex Medical School, Brighton and Sussex University Hospitals, Eastern Road, Brighton BN2 5BE, UK; heike.rabe{at}bsuh.nhs.uk

Abstract

During the transition to extrauterine life, preterm infants are at high risk of developing circulatory failure. Currently, hypotension is used as major diagnostic criteria for starting treatments such as fluid boluses, inotropes or steroids. Most of these treatment options have not been studied in large randomised controlled trials for efficacy and safety and are under discussions. A wide variety in their use is reported in the literature and clear evidence about which inotrope or other treatment should be preferred is lacking. In addition, there is ongoing debate about the appropriate threshold values for blood pressure. Other diagnostic measures for poor circulation are functional echocardiography, near-infrared spectroscopy, capillary refill time, base excess and serum lactate. Large randomised controlled trials for the use of dopamine and dobutamine in preterm infants <32 weeks gestation are under way to fill the knowledge gaps on the assessment of circulatory compromise and on efficacy and safety of the studied age-appropriate drug formulations.

  • prematurity
  • transition after birth
  • inotropes

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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