Permissive hypotension in extremely low birth weight infants (≤1000 gm).
OBJECTIVE
We performed this study to evaluate the safety of permissive hypotension management in extremely low birth weight infants (ELBWIs).


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 (≥stage 3) and bronchopulmonary dysplasia (≥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.


CONCLUSIONS
Close observation of hypotensive ELBWIs who showed good clinical perfusion signs without intervention allowed to avoid unnecessary medications and resulted in good neurological outcomes.
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
So Yoon
SY
Ahn
Eun Sun
ES
Kim
Jin Kyu
JK
Kim
Jeong Hee
JH
Shin
Se In
SI
Sung
Ji Mi
JM
Jung
Yun Sil
YS
Chang
Won Soon
WS
Park
D001034:Apgar Score; D001724:Birth Weight / Q000502:physiology; D005260:Female; D006801:Humans; D007022:Hypotension / Q000503:physiopathology*; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male