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Vasopressin versus Dopamine for Treatment of Hypotension in Extremely Low Birth Weight Infants: A Randomized, Blinded Pilot Study
Journal article   Open access   Peer reviewed

Vasopressin versus Dopamine for Treatment of Hypotension in Extremely Low Birth Weight Infants: A Randomized, Blinded Pilot Study

Danielle R. Rios and Jeffrey R. Kaiser
The Journal of pediatrics, Vol.166(4), pp.850-855
04/01/2015
DOI: 10.1016/j.jpeds.2014.12.027
PMCID: PMC4380753
PMID: 25641242
url
https://www.ncbi.nlm.nih.gov/pmc/articles/4380753View
Open Access

Abstract

Objective To evaluate vasopressin vs dopamine as initial therapy in extremely low birth weight (ELBW) infants with hypotension during the first 24 hours of life. Study design ELBW infants with hypertension <= 30 weeks' gestation and <= 24 hours old randomly received treatment with vasopressin or dopamine in a blinded fashion. Normotensive infants not receiving vasopressor support served as a comparison group. Results Twenty ELBW infants with hypertension received vasopressin (n = 10) or dopamine (n = 10), and 50 were enrolled for comparison. Mean gestational age was 25.6 +/- 1.4 weeks and birth weight 705 +/- 154 g. Response to vasopressin paralleled that of dopamine in time to adequate mean blood pressure (Kaplan-Meier curve, P = .986); 90% of infants in each treatment group responded with adequate blood pressure. The vasopressin group received fewer doses of surfactant (P < .05), had lower PaCO2 values (P < .05), and were not tachycardic (P < .001) during vasopressin administration, compared with the dopamine group. Conclusions Vasopressin in ELBW infants as the initial agent for early hypotension appeared safe. This pilot study supports a larger randomized controlled trial of vasopressin vs dopamine therapy in ELBW infants with hypotension.
Pediatrics Life Sciences & Biomedicine Science & Technology

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