Abstract
Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required. Based on a literature search on published reports, meta-analytic reviews, and selected abstracts, this review discusses the current available information on pharmacologic actions, clinical effects, and side effects of commonly used antihypotensive medications including dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, and milrinone in preterm neonates.
Highlights
Specialty section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics
Antihypotensive treatments are often started in response to a low blood pressure (BP) or signs of low cardiac output (CO) in critically ill neonates
A national Canadian database reported that 10% of neonates of
Summary
Specialty section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics. The challenge for clinicians in the neonatal intensive care unit (NICU) is to dissect out the etiology of the hemodynamic changes, decide if the changes are pathologic or transitionally appropriate, and tailor the treatment regimen for the patient, the condition, and gestation. A Norwegian population database study indicated that 2.7% of all NICU patients received inotropes at any point of their NICU stay; 28 and 4.1% of
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