Journal article
Use of Antihypotensive Therapies in Extremely Preterm Infants
Pediatrics (Evanston), Vol.131(6), pp.e1865-e1873
06/2013
DOI: 10.1542/peds.2012-2779
PMCID: PMC3666108
PMID: 23650301
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 230/7 to 266/7 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.
Details
- Title: Subtitle
- Use of Antihypotensive Therapies in Extremely Preterm Infants
- Creators
- Edward F Bell - Department of Pediatrics, University of Iowa, Iowa City, IowaBeau Batton - Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OhioLei Li - Statistics & Epidemiology Unit, RTI International, Research Triangle Park, North CarolinaNancy S Newman - Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OhioAbhik Das - Statistics & Epidemiology Unit, RTI International, Rockville, MarylandKristi L Watterberg - University of New Mexico Health Sciences Center, Albuquerque, New MexicoBradley A Yoder - Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UtahRoger G Faix - Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UtahMatthew M Laughon - Department of Pediatrics, University of North Carolina, Chapel Hill, North CarolinaBarbara J Stoll - Department of Pediatrics, Emory University School of Medicine & Children’s Healthcare of Atlanta, Atlanta, GeorgiaKrisa P Van Meurs - Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CaliforniaWaldemar A Carlo - Division of Neonatology, University of Alabama at Birmingham, Birmingham, AlabamaBrenda B Poindexter - Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IndianaPablo J Sánchez - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TexasRichard A Ehrenkranz - Department of Pediatrics, Yale University School of Medicine, New Haven, ConnecticutRonald N Goldberg - Department of Pediatrics, Duke University, Durham, North CarolinaAbbot R Laptook - Department of Pediatrics, Women & Infants’ Hospital, Brown University, Providence, Rhode IslandKathleen A Kennedy - Department of Pediatrics, University of Texas Medical School at Houston, Houston, TexasIvan D Frantz - Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, MassachusettsSeetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, MichiganKurt Schibler - Department of Pediatrics, Cincinnati Children’s Hospital Medical Center & University of Cincinnati College of Medicine, Cincinnati, Ohio; andRosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, Bethesda, MarylandMichele C Walsh - Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OhioEunice Kennedy Shriver National Institute of Child Health & Human Development Neonatal Research Network
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.131(6), pp.e1865-e1873
- DOI
- 10.1542/peds.2012-2779
- PMID
- 23650301
- PMCID
- PMC3666108
- NLM abbreviation
- Pediatrics
- ISSN
- 0031-4005
- eISSN
- 1098-4275
- Publisher
- American Academy of Pediatrics
- Language
- English
- Date published
- 06/2013
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093489402771
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