title: Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life.
abstract: OBJECTIVE
  To evaluate lowest mean arterial blood pressure during the first 24 h of life (minMAP(24)) in very-low-birthweight (VLBW) infants and to identify associations between hypotension and short-term outcome.
  
  
  METHODS
  Retrospective cohort analysis of the minMAP(24) of 4907 VLBW infants with a gestational age <32 weeks in correlation with clinical data. Hypotension was defined as minMAP(24) being lower than the median value of all patients of the same gestational age.
  
  
  RESULTS
  MinMAP(24) values correlated with gestational age. Median minMAP(24) values of VLBW infants ≤29 weeks' gestation were 1-2 mm Hg lower than gestational age in completed weeks. Hypotensive infants had a higher rate of intraventricular haemorrhage (IVH, 20.3% vs 15.9%, p<0.001), bronchopulmonary dysplasia (BPD, 19.2% vs 15.1%, p<0.001) and death (5.2% vs 3.0%, p<0.001). Multivariate logistic regression analyses, including potential confounders, confirmed these data. MinMAP(24) was an independent risk factor for IVH (OR 0.97/mm Hg, 95% CI 0.96 to 0.99, p=0.003), BPD (OR 0.96/mm Hg, 95% CI 0.94 to 0.98, p<0.001) and mortality (OR 0.94/mm Hg, 95% CI 0.90 to 0.98, p=0.003).
  
  
  CONCLUSIONS
  Hypotension during the first 24 h of life is associated with adverse outcomes in VLBW infants. This underlines the need for randomised controlled trials on the use of vasoactive drugs in this vulnerable patient cohort.
authors.affiliation: Department of Paediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Kirstin
authors.initials: K
authors.lastname: Faust
authors.affiliation: Department of Paediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Härtel
authors.affiliation: Institute of Medical Biometrics and Statistics, University of Lübeck, Lübeck, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Preuß
authors.affiliation: Academic Department of Paediatrics, Brighton & Sussex Medical School, Brighton, UK.
authors.forename: Heike
authors.initials: H
authors.lastname: Rabe
authors.affiliation: Department of Neonatology, Vest Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Roll
authors.affiliation: Department of Neonatology, Vivantes Hospital, Berlin-Neukölln, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Emeis
authors.affiliation: Department of Neonatology, Children's Hospital Aschaffenburg, Aschaffenburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wieg
authors.affiliation: Department of Neonatology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Miklos
authors.initials: M
authors.lastname: Szabo
authors.affiliation: Department of Paediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Egbert
authors.initials: E
authors.lastname: Herting
authors.affiliation: Department of Paediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Göpel
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications; D005865:Gestational Age; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000175:diagnosis; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Neonatology; blood pressure; hypotension; preterm infant