ArticleJournal of perinatology : official journal of the California Perinatal Association2006
Diagnostic criteria and therapeutic interventions for the hypotensive very low birth weight infant.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Decision-making at the limit of viability: the Austrian neonatal choice context.BMC pediatrics · 2019Pooled it
- Vasopressin and its analogues for the treatment of refractory hypotension in neonates.The Cochrane database of systematic reviews · 2013Pooled it
- Treating hypotension in the preterm infant: when and with what: a critical and systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2007Pooled it
- Hypotension in Preterm Infants (HIP) randomised trial.Archives of disease in childhood. Fetal and neonatal edition · 2021Trial
- Propofol for endotracheal intubation in neonates: a dose-finding trial.Archives of disease in childhood. Fetal and neonatal edition · 2020Trial
- Use of antihypotensive therapies in extremely preterm infants.Pediatrics · 2013Trial
- Feasibility study of early blood pressure management in extremely preterm infants.The Journal of pediatrics · 2012Trial
- A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates.Journal of perinatology : official journal of the California Perinatal Association · 2008Trial
- Calibrated abdominal compression to assess fluid responsiveness in extremely and very preterm neonates: a pilot study.Frontiers in pediatrics · 2026Article
- Cumulative Hydrocortisone Exposure and Early Brain Volumetrics in Very Low Birth Weight Infants: Associations with Neurodevelopmental Outcomes.Biomedicines · 2025Article
- Non-Invasive Blood Pressure Measurement in Extremely Preterm Neonates: Comparative Analysis of Different Methods.Indian pediatrics · 2025Article
- Neonatal Shock: Current Dilemmas and Future Research Avenues.Children (Basel, Switzerland) · 2025Review
- Vasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns.Journal of perinatology : official journal of the California Perinatal Association · 2024Observational
- The prediction of estimated cerebral perfusion pressure with trans-systolic time in preterm and term infants.European journal of pediatrics · 2024Article
- A survey on management practices of hypotension in preterm neonates: an Indian perspective.Frontiers in pediatrics · 2024Article
- Monitoring and evaluation of hypotension in the extremely preterm.Frontiers in cardiovascular medicine · 2024Review
- Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants.Journal of Korean Neurosurgical Society · 2023Article
- Evaluation of the Hypotensive Preterm Infant: Evidence-Based Practice at the Bedside?Children (Basel, Switzerland) · 2023Review
- Comparison of clinical outcomes between active and permissive blood pressure management in extremely preterm infants.NIHR open research · 2023Article
- Maximum vasoactive-inotropic score and mortality in extremely premature, extremely low birth weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2021Observational
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe diagnosis and management of hypotension in the very low birth weight (VLBW) is a controversial area.
objectiveTo establish if there is any consensus in the diagnostic criteria and therapeutic interventions in the hypotensive VLBW among neonatologists in Canada.
methodsA postal questionnaire was sent to neonatologists in all level II and III neonatal intensive care units throughout Canada.
resultsIn total, 120 questionnaires were sent. Ninety-five completed questionnaires were returned. Seventy-six percent of respondents work in units where at least 50 VLBWs and 43% where at least 100 VLBWs are cared for annually. Fifty-seven percent of the respondents have at least 10 years experience as practicing neonatologists. 25.8% rely on blood pressure values alone when intervening, the most common being a blood pressure less than gestational age in weeks. Ninety-seven percent of respondents commence therapy with a fluid bolus. Normal saline is the predominant volume administered (95%). Dopamine remains the pressor of choice. Great variation exists in starting doses and total amount administered. Similar variation exists with epinephrine, with tenfold differences in starting doses (0.01-0.1 mcg/kg/min) and tenfold differences in maximum dose (0.4-4 mc/kg/min) administered. Steroid doses used ranged from 0.1 mg/kg/dose of hydrocortisone to 5 mg/kg/dose. Bicarbonate is rarely used. Three predominant therapeutic regimes exist. These include (i) volume followed by dopamine then a steroid (32%), (ii) volume, dopamine, dobutamine (29%), (iii) volume, dopamine, epinephrine (22%).
conclusionThis is the first large study of practices among neonatologists addressing hypotension in the VLBW infant. There is wide variation in practice, which is a reflection of the lack of good evidence currently available for this very common problem.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.