PT  - JOURNAL ARTICLE
AU  - Kirstin Faust
AU  - Christoph Härtel
AU  - Michael Preuß
AU  - Heike Rabe
AU  - Claudia Roll
AU  - Michael Emeis
AU  - Christian Wieg
AU  - Miklos Szabo
AU  - Egbert Herting
AU  - Wolfgang Göpel
TI  - Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life
AID  - 10.1136/archdischild-2014-306483
DP  - 2015 Sep 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F388--F392
VI  - 100
IP  - 5
4099  - http://fn.bmj.com/content/100/5/F388.short
4100  - http://fn.bmj.com/content/100/5/F388.full
SO  - Arch Dis Child Fetal Neonatal Ed2015 Sep 01; 100
AB  - 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.