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Haemodynamic assessment and management of hypotension in the preterm
  1. Rachel Mullaly,
  2. Afif Faisal El-Khuffash
  1. Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Dr Afif Faisal El-Khuffash, Department of Neonatology, The Rotunda Hospital, Dublin, D01 P5W9, Ireland; afif_faisal{at}


The management of low blood flow states in premature neonates is fraught with many challenges. We remain over-reliant on regimented stepwise protocols that use mean blood pressure as a threshold for intervention to guide treatment, without giving due consideration to the underlying pathophysiology. The current available evidence does not reflect the need to concentrate on the unique pathophysiology of the preterm infant and thus leads to widespread misuse of vasoactive agents that often do not provide the desired clinical effect. Therefore, understanding the underlying pathophysiological underpinnings of haemodynamic compromise may better guide choice of agent and assess physiological response to the selected intervention.

  • Neonatology
  • Cardiology
  • Intensive Care Units, Neonatal

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No data are available. Not Applicable.

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  • Contributors Both authors substantially contributed to the conception and design of the article and the interpretation of the relevant literature, and take public responsibility for the content of the work submitted for review. RM drafted the article and AFE-K revised it critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.