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J Perinatol. 2014 Apr;34(4):301-5. doi: 10.1038/jp.2014.6. Epub 2014 Feb 6.

Evolving blood pressure dynamics for extremely preterm infants.

Author information

1
1] Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA [2] Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, IL, USA.
2
Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA.
3
Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
4
Statistics and Epidemiology Unit, RTI International, Rockville, MD, USA.
5
Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
6
Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
7
Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.
8
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
9
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.

Abstract

OBJECTIVE:

To examine changes in arterial blood pressure (ABP) after birth in extremely preterm infants.

STUDY DESIGN:

Prospective observational study of infants 23(0/7) to 26(6/7) weeks gestational age (GA). Antihypotensive therapy use and ABP measurements were recorded for the first 24 h.

RESULT:

A cohort of 367 infants had 18 709 ABP measurements recorded. ABP decreased for the first 3 h, reached a nadir at 4 to 5 h and then increased at an average rate of 0.2 mm Hg h(-1). The rise in ABP from hour 4 to 24 was similar for untreated infants (n=164) and infants given any antihypotensive therapy (n=203), a fluid bolus (n=135) or dopamine (n=92). GA-specific trends were similar. ABP tended to be lower as GA decreased, but varied widely at each GA.

CONCLUSION:

ABP increased spontaneously over the first 24 postnatal hours for extremely preterm infants. The rate of rise in ABP did not change with antihypotensive therapy.

PMID:
24503912
PMCID:
PMC3982788
DOI:
10.1038/jp.2014.6
[Indexed for MEDLINE]
Free PMC Article

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