title: Trends in pharmacotherapy for neonatal hypotension.
abstract: OBJECTIVE
  To determine trends in pharmacotherapy for neonatal hypotension in all infants and in extremely low birth weight (ELBW, birth weight 300-1000 g) infants.
  
  
  METHODS
  We queried the Pediatric Health Information System database for all infants ≤28 days with a diagnosis code for hypotension that were discharged between January 2001 and December 2012. Patients were excluded if they had complex congenital heart disease or cardiac surgery, sepsis or meningitis, or had extracorporeal membrane oxygenation. We determined trends in pharmacotherapy for hypotension in all infants and ELBW infants, an especially vulnerable group.
  
  
  RESULTS
  A total of 8019 hypotensive infants met study criteria. The 2 most prescribed medications were dopamine (65.3%) and dobutamine (19.9%). For 1487 hypotensive ELBW infants, the 2 most prescribed medications were dopamine (83.4%) and hydrocortisone (33%). During the study period, the use of dobutamine decreased, and hydrocortisone and vasopressin use increased for all infants and for ELBW infants.
  
  
  CONCLUSIONS
  Treatment of neonatal hypotension varies widely between institutions and individual practitioners, and pharmacotherapy for neonatal hypotension has changed over the past decade. Although dopamine and dobutamine were the most frequently used agents, their use has declined and the uses of hydrocortisone and vasopressin have increased.
authors.affiliation: Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX. Electronic address: drrios@texaschildrens.org.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Rios
authors.affiliation: Department of Pharmacy, Texas Children's Hospital, Houston, TX.
authors.forename: Brady S
authors.initials: BS
authors.lastname: Moffett
authors.affiliation: Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX; Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Kaiser
mesh_terms: D001794:Blood Pressure; D004280:Dobutamine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D004358:Drug Therapy / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007022:Hypotension / Q000188:drug therapy*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D008297:Male; D008581:Meningitis / Q000188:drug therapy; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D014667:Vasopressins / Q000627:therapeutic use
chemical_list: D014667:Vasopressins; D004280:Dobutamine; D004298:Dopamine; D006854:Hydrocortisone