Eric S Peeples1,2, Bryan A Comstock3, Patrick J Heagerty3, Sandra E Juul4. 1. Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA. epeeples@childrensomaha.org. 2. Child Health Research Institute, Omaha, NE, USA. epeeples@childrensomaha.org. 3. Department of Biostatistics, University of Washington, Seattle, WA, USA. 4. Department of Pediatrics, University of Washington, Seattle, WA, USA.
Abstract
OBJECTIVE: To describe high/low daily blood pressures (BP) and variability in BP management with vasoactive infusions (VI) and/or hydrocortisone (HC) in extremely preterm infants. STUDY DESIGN: Analysis of data from 24-27 weeks' gestation infants in the Preterm Erythropoietin Neuroprotection (PENUT) Trial. Daily high/low BPs, the use of VI and/or HC, and adverse outcomes were compared descriptively and using regression models. RESULTS: 936 infants were included; 64% untreated, 20% VI, 3% HC, and 13% VI + HC. BP ranges are described for the 602 untreated infants. Considerable inter- and intra-center variability was demonstrated in the rate of VI and/or HC use and the lowest BP on the day of VI or HC initiation. CONCLUSIONS: Despite published expert opinion guidance regarding BP management in extremely preterm infants, our results suggest a continued lack of consensus result in both inter- and intra-center variability in practice. Well-designed studies in the field are urgently needed.
OBJECTIVE: To describe high/low daily blood pressures (BP) and variability in BP management with vasoactive infusions (VI) and/or hydrocortisone (HC) in extremely preterm infants. STUDY DESIGN: Analysis of data from 24-27 weeks' gestation infants in the Preterm Erythropoietin Neuroprotection (PENUT) Trial. Daily high/low BPs, the use of VI and/or HC, and adverse outcomes were compared descriptively and using regression models. RESULTS: 936 infants were included; 64% untreated, 20% VI, 3% HC, and 13% VI + HC. BP ranges are described for the 602 untreated infants. Considerable inter- and intra-center variability was demonstrated in the rate of VI and/or HC use and the lowest BP on the day of VI or HC initiation. CONCLUSIONS: Despite published expert opinion guidance regarding BP management in extremely preterm infants, our results suggest a continued lack of consensus result in both inter- and intra-center variability in practice. Well-designed studies in the field are urgently needed.
Authors: Beau Batton; Lei Li; Nancy S Newman; Abhik Das; Kristi L Watterberg; Bradley A Yoder; Roger G Faix; Matthew M Laughon; Barbara J Stoll; Krisa P Van Meurs; Waldemar A Carlo; Brenda B Poindexter; Edward F Bell; Pablo J Sánchez; Richard A Ehrenkranz; Ronald N Goldberg; Abbot R Laptook; Kathleen A Kennedy; Ivan D Frantz; Seetha Shankaran; Kurt Schibler; Rosemary D Higgins; Michele C Walsh Journal: Pediatrics Date: 2013-05-06 Impact factor: 7.124
Authors: So Yoon Ahn; Eun Sun Kim; Jin Kyu Kim; Jeong Hee Shin; Se In Sung; Ji Mi Jung; Yun Sil Chang; Won Soon Park Journal: Yonsei Med J Date: 2012-07-01 Impact factor: 2.759