Melisa J Oca1, Martha Nelson, Steven M Donn. 1. Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0254, USA.
Abstract
OBJECTIVES: This study was designed to assess the comparative efficacy of normal saline (NS) and 5% albumin (ALB) for treatment of hypotension in the acutely ill newborn. STUDY DESIGN:Newborn infants who were < 24 hours old and were admitted to the Holden Neonatal Intensive Care Unit at the University of Michigan were randomized to receive one of the two solutions for volume expansion. Hypotension was defined as a sustained (> or =30 minutes) mean arterial pressure (MAP) of <; 30 mmHg for infants weighing < or =2500 g, or a MAP of < 40 mmHg for those weighing > 2500 g. The short-term outcome measure was the resolution of hypotension defined as a MAP over the minimum limits set for birthweight sustained for > or =30 minutes. RESULTS:In total 41 infants met criteria and were entered. Of these, 21 infants received ALB and 20 received NS. Successful treatment was seen in 17/21 (81%) of infants in the ALB group and 17/20 (85%) of infants in the NS group. There was no statistically significant difference in response to treatment (p=0.30). In addition, there was no statistically significant difference in the magnitude of change in MAP between the two (p=0.41). CONCLUSIONS:NS was shown to be as effective as ALB for the correction of acute hypotension in the newborn infant. Given comparable efficacy of NS, along with its relatively low cost and availability, it should be considered the initial treatment of choice in this setting.
RCT Entities:
OBJECTIVES: This study was designed to assess the comparative efficacy of normal saline (NS) and 5% albumin (ALB) for treatment of hypotension in the acutely ill newborn. STUDY DESIGN: Newborn infants who were < 24 hours old and were admitted to the Holden Neonatal Intensive Care Unit at the University of Michigan were randomized to receive one of the two solutions for volume expansion. Hypotension was defined as a sustained (> or =30 minutes) mean arterial pressure (MAP) of < 30 mmHg for infants weighing < or =2500 g, or a MAP of < 40 mmHg for those weighing > 2500 g. The short-term outcome measure was the resolution of hypotension defined as a MAP over the minimum limits set for birthweight sustained for > or =30 minutes. RESULTS: In total 41 infants met criteria and were entered. Of these, 21 infants received ALB and 20 received NS. Successful treatment was seen in 17/21 (81%) of infants in the ALB group and 17/20 (85%) of infants in the NS group. There was no statistically significant difference in response to treatment (p=0.30). In addition, there was no statistically significant difference in the magnitude of change in MAP between the two (p=0.41). CONCLUSIONS: NS was shown to be as effective as ALB for the correction of acute hypotension in the newborn infant. Given comparable efficacy of NS, along with its relatively low cost and availability, it should be considered the initial treatment of choice in this setting.
Authors: Joe Brierley; Joseph A Carcillo; Karen Choong; Tim Cornell; Allan Decaen; Andreas Deymann; Allan Doctor; Alan Davis; John Duff; Marc-Andre Dugas; Alan Duncan; Barry Evans; Jonathan Feldman; Kathryn Felmet; Gene Fisher; Lorry Frankel; Howard Jeffries; Bruce Greenwald; Juan Gutierrez; Mark Hall; Yong Y Han; James Hanson; Jan Hazelzet; Lynn Hernan; Jane Kiff; Niranjan Kissoon; Alexander Kon; Jose Irazuzta; Jose Irazusta; John Lin; Angie Lorts; Michelle Mariscalco; Renuka Mehta; Simon Nadel; Trung Nguyen; Carol Nicholson; Mark Peters; Regina Okhuysen-Cawley; Tom Poulton; Monica Relves; Agustin Rodriguez; Ranna Rozenfeld; Eduardo Schnitzler; Tom Shanley; Saraswati Kache; Sara Skache; Peter Skippen; Adalberto Torres; Bettina von Dessauer; Jacki Weingarten; Timothy Yeh; Arno Zaritsky; Bonnie Stojadinovic; Jerry Zimmerman; Aaron Zuckerberg Journal: Crit Care Med Date: 2009-02 Impact factor: 7.598
Authors: Ana Cristina A Tannuri; Luanna M Silva; Antonio José G Leal; Augusto César F de Moraes; Uenis Tannuri Journal: Clinics (Sao Paulo) Date: 2012 Impact factor: 2.365
Authors: Marc R Mendler; Stephan Schwarz; Lisbeth Hechenrieder; Steven Kurth; Birte Weber; Severin Höfler; Miriam Kalbitz; Benjamin Mayer; Helmut D Hummler Journal: Front Pediatr Date: 2018-07-10 Impact factor: 3.418