title: Use of antihypotensive therapies in extremely preterm infants.
abstract: OBJECTIVE
  To investigate the relationships among blood pressure (BP) values, antihypotensive therapies, and in-hospital outcomes to identify a BP threshold below which antihypotensive therapies may be beneficial.
  
  
  METHODS
  Prospective observational study of infants 23(0/7) to 26(6/7) weeks' gestational age. Hourly BP values and antihypotensive therapy use in the first 24 hours were recorded. Low BP was investigated by using 15 definitions. Outcomes were examined by using regression analysis controlling for gestational age, the number of low BP values, and illness severity.
  
  
  RESULTS
  Of 367 infants enrolled, 203 (55%) received at least 1 antihypotensive therapy. Treated infants were more likely to have low BP by any definition (P < .001), but for the 15 definitions of low BP investigated, therapy was not prescribed to 3% to 49% of infants with low BP and, paradoxically, was administered to 28% to 41% of infants without low BP. Treated infants were more likely than untreated infants to develop severe retinopathy of prematurity (15% vs 8%, P = .03) or severe intraventricular hemorrhage (22% vs 11%, P < .01) and less likely to survive (67% vs 78%, P = .02). However, with regression analysis, there were no significant differences between groups in survival or in-hospital morbidity rates.
  
  
  CONCLUSIONS
  Factors other than BP contributed to the decision to use antihypotensive therapies. Infant outcomes were not improved with antihypotensive therapy for any of the 15 definitions of low BP investigated.
authors: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA. bbatton@siumed.edu
authors: Beau
authors: B
authors: Batton
authors: Lei
authors: L
authors: Li
authors: Nancy S
authors: NS
authors: Newman
authors: Abhik
authors: A
authors: Das
authors: Kristi L
authors: KL
authors: Watterberg
authors: Bradley A
authors: BA
authors: Yoder
authors: Roger G
authors: RG
authors: Faix
authors: Matthew M
authors: MM
authors: Laughon
authors: Barbara J
authors: BJ
authors: Stoll
authors: Krisa P
authors: KP
authors: Van Meurs
authors: Waldemar A
authors: WA
authors: Carlo
authors: Brenda B
authors: BB
authors: Poindexter
authors: Edward F
authors: EF
authors: Bell
authors: Pablo J
authors: PJ
authors: Sánchez
authors: Richard A
authors: RA
authors: Ehrenkranz
authors: Ronald N
authors: RN
authors: Goldberg
authors: Abbot R
authors: AR
authors: Laptook
authors: Kathleen A
authors: KA
authors: Kennedy
authors: Ivan D
authors: ID
authors: Frantz
authors: Seetha
authors: S
authors: Shankaran
authors: Kurt
authors: K
authors: Schibler
authors: Rosemary D
authors: RD
authors: Higgins
authors: Michele C
authors: MC
authors: Walsh
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000188:drug therapy*; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome
keywords: antihypotensive therapy; blood pressure; extremely preterm infant; hypotension
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