Evolving blood pressure dynamics for extremely preterm infants

Abstract

Objective:To examine changes in arterial blood pressure (ABP) after birth in extremely preterm infants.Study Design:Prospective observational study of infants 23 0/7 to 26 6/7 weeks gestational age (GA). Antihypotensive therapy use and ABP measurements were recorded for the first 24 h.Result:A cohort of 367 infants had 18 709 ABP measurements recorded. ABP decreased for the first 3 h, reached a nadir at 4 to 5 h and then increased at an average rate of 0.2 mm Hg h -1. The rise in ABP from hour 4 to 24 was similar for untreated infants (n=164) and infants given any antihypotensive therapy (n=203), a fluid bolus (n=135) or dopamine (n=92). GA-specific trends were similar. ABP tended to be lower as GA decreased, but varied widely at each GA.Conclusion:ABP increased spontaneously over the first 24 postnatal hours for extremely preterm infants. The rate of rise in ABP did not change with antihypotensive therapy. © 2014 Nature America, Inc.