ArticleArchives of disease in childhood. Fetal and neonatal edition2009
Permissive hypotension in the extremely low birthweight infant with signs of good perfusion.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 185 citations in OpenAlex.
- Pooled it
- A meta-analysis of dopamine use in hypotensive preterm infants: blood pressure and cerebral hemodynamics.Journal of perinatology : official journal of the California Perinatal Association · 2011Pooled it
- Cerebral oxygen saturation and autoregulation during hypotension in extremely preterm infants.Pediatric research · 2021Trial
- Hypotension in Preterm Infants (HIP) randomised trial.Archives of disease in childhood. Fetal and neonatal edition · 2021Trial
- Prospective risk factor monitoring reduces intracranial hemorrhage rates in preterm infants.Deutsches Arzteblatt international · 2013Trial
- 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
- Caring for the smallest hearts: cardiovascular phenotypes and assessment in tiny babies.Pediatric research · 2026Review
- A FAR-Out approach for evaluating the impact of clinical practice changes on severe intracranial hemorrhage in preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study.BMC pediatrics · 2025Article
- Cerebral autoregulation monitoring in neonates and infants after cardiac surgery with cardiopulmonary bypass - comparison of single ventricle and biventricular physiology.Frontiers in pediatrics · 2025Article
- An Update on Pharmacologic Management of Neonatal Hypotension: When, Why, and Which Medication.Children (Basel, Switzerland) · 2024Review
- A survey on management practices of hypotension in preterm neonates: an Indian perspective.Frontiers in pediatrics · 2024Article
- Preterm Infants off Positive Pressure Respiratory Support Have a Higher Incidence of Occult Cerebral Hypoxia.The Journal of pediatrics · 2023Observational
- Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants.Journal of Korean Neurosurgical Society · 2023Article
- Comparison of clinical outcomes between active and permissive blood pressure management in extremely preterm infants.NIHR open research · 2023Article
- The role of human milk feeds on inotrope use in newborn infants with sepsis.Frontiers in pediatrics · 2023Article
- [Influence of hypotension on the short-term prognosis of preterm infants with a gestational age of <32 weeks].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2022Article
- A Quality Improvement Bundle to Improve Outcomes in Extremely Preterm Infants in the First Week.Pediatrics · 2022Article
- In-hospital Outcomes and Early Hemodynamic Management According to Echocardiography Use in Hypotensive Preterm Infants: A National Propensity-Matched Cohort Study.Frontiers in cardiovascular medicine · 2022Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMany practitioners routinely treat infants whose mean arterial blood pressure in mm Hg is less than their gestational age in weeks (GA).
objectiveTo assess the effectiveness of utilising a combined approach of clinical signs, metabolic acidosis and absolute blood pressure (BP) values when deciding to treat hypotension in the extremely low birthweight (ELBW) infant.
methodsRetrospective cohort study of all live born ELBW infants admitted to our neonatal intensive care unit over a 4-year period. Patients were grouped as either normotensive (BP never less than GA), hypotensive and not treated (BP<GA but signs of good perfusion; we termed this permissive hypotension) and hypotensive treated (BP<GA with signs of poor perfusion).
results118 patients were admitted during this period. Blood pressure data were available on 108 patients. 53% of patients were hypotensive (mean BP in mm Hg less than GA in weeks). Treated patients had lower birth weight and GA, and significantly lower blood pressure at 6, 12, 18 and 24 h. Normotensive patients and patients designated as having permissive hypotension had similar outcomes. Mean blood pressure in the permissive group increased from 26 mm Hg at 6 h to 31 mm Hg at 24 h. In a logistic regression model, treated hypotension is independently associated with mortality, odds ratio 8.0 (95% CI 2.3 to 28, p<0.001).
conclusionsBlood pressure spontaneously improves in ELBW infants during the first 24 h. Infants hypotensive on GA criteria but with clinical evidence of good perfusion had as good an outcome as normotensive patients. Treated low blood pressure was associated with adverse outcome.
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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.