Neonatal Med.  2014 May;21(2):99-105. 10.5385/nm.2014.21.2.99.

Optimal Blood Pressure in Preterm Infants

• Park HK

• KMID: 2052155
• DOI: http://doi.org/10.5385/nm.2014.21.2.99

Abstract

Many neonatologists routinely treat infants whose mean arterial blood pressure in mm Hg is less than their gestational age in weeks (GA) but there is uncertainty regarding diagnosis and treatment of hypotension. This addresses the definition of permissive hypotension based on the principles of cardiovascular physiology, and reviews the tools available at the bedside to examine the complex relationship among blood pressure, systemic organ blood flow, and tissue oxygen delivery and oxygen demand in preterm infants (skin color, capillary refill time, urine output, serum lactate level, and acidosis). Importantly, absolute blood pressure values are only one indicator of circulatory status and this review confirms that a mean blood pressure less than gestational age in weeks alone is not a predictor of poor outcome. Global assessment of cardiovascular status and intervention for hypotension restricted to infants with poor perfusion may be associated with good clinical outcomes and should be further evaluated.

Keyword

Hypotension; Preterm infant; Systemic blood flow; Echocardiography

MeSH Terms

Arterial Pressure
Blood Pressure*
Capillaries
Cardiovascular Physiological Phenomena
Diagnosis
Echocardiography
Gestational Age
Humans
Hypotension
Infant
Infant, Newborn
Infant, Premature*
Lactic Acid
Oxygen
Perfusion
Uncertainty
Lactic Acid
Oxygen