Permissive Hypotension in Extremely Low Birth Weight Infants (< or =1000 gm).
10.3349/ymj.2012.53.4.765
- Author:
So Yoon AHN
1
;
Eun Sun KIM
;
Jin Kyu KIM
;
Jeong Hee SHIN
;
Se In SUNG
;
Ji Mi JUNG
;
Yun Sil CHANG
;
Won Soon PARK
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
- Publication Type:Original Article
- Keywords:
Hypotension;
prognosis;
infant;
extremely low birth weight
- MeSH:
Apgar Score;
Birth Weight/physiology;
Female;
Humans;
Hypotension/*physiopathology;
Infant, Extremely Low Birth Weight/*physiology;
Infant, Newborn;
Male
- From:Yonsei Medical Journal
2012;53(4):765-771
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We performed this study to evaluate the safety of permissive hypotension management in extremely low birth weight infants (ELBWIs). MATERIALS AND METHODS: Medical records of all inborn ELBWIs admitted to Samsung Medical Center from January 2004 to December 2008 were reviewed retrospectively. Of a total of 261 ELBWIs, 47 (18%) required treatment for hypotension (group T), 110 (42%) remained normotensive (group N), and 104 (40%) experienced more than one episode of hypotension without treatment (group P) during the first 72 hours of life. Treatment of hypotension included inotropic support and/or fluid loading. RESULTS: Birth weight and Apgar scores were significantly lower in the T group than the other two groups. In the N group, the rate of pathologically confirmed maternal chorioamnionitis was significantly higher than other two groups, and the rate was higher in the P group than the T group. After adjusting for covariate factors, no significant differences in mortality and major morbidities were found between the N and P groups. However, the mortality rate and the incidence of intraventricular hemorrhage (> or =stage 3) and bronchopulmonary dysplasia (> or =moderate) were significantly higher in the T group than the other two groups. Long term neurodevelopmental outcomes were not significantly different between the N and P groups. CONCLUSION: Close observation of hypotensive ELBWIs who showed good clinical perfusion signs without intervention allowed to avoid unnecessary medications and resulted in good neurological outcomes.
