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5 *MYTHS* about HYPOTENSION in infants// + 5 BP PEARLS!!

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Tala Talks NICU

Dopamine?! Steroids?! Fluid bolus?!// When to echo??!! Sooo much we all THINK we KNOW about neonatal BPs and here we cover those myths! Are CUFF pressures accurate in babies? Is DOPAMINE the best drug? What about volume boluses? When should we get an ECHO of the heart?!! When should we consider STEROIDS?? In part II of these series we delve into all these questions!!

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Dr. Tala is double boarded in Neonatology and Pediatrics and has worked in busy level III and IV units for the past 16 years. She has won multiple teaching awards throughout her time as a neonatologist.

References:
Giesinger RE, McNamara PJ. Hemodynamic instability in the critically ill neonate: An approach to cardiovascular support based on disease pathophysiology. Semin Perinatol. 2016 Apr;40(3):17488. doi: 10.1053/j.semperi.2015.12.005. Epub 2016 Jan 14. PMID: 26778235.

Mullaly R, ElKhuffash AF. Haemodynamic assessment and management of hypotension in the preterm. Arch Dis Child Fetal Neonatal Ed. 2024 Feb 19;109(2):120127. doi: 10.1136/archdischild2022324935. PMID: 37173119.

König, Kai, Dan M. Casalaz, Emily J. Burke, and Andrew Watkins. "Accuracy of noninvasive blood pressure monitoring in very preterm infants." Intensive care medicine 38 (2012): 670676.

Rahde Bischoff A, Bhombal S, Altman CA, Fraga MV, Punn R, Rohatgi RK, Lopez L, McNamara PJ. Targeted Neonatal Echocardiography in Patients With Hemodynamic Instability. Pediatrics. 2022 Nov 1;150(Suppl 2):e2022056415I. doi: 10.1542/peds.2022056415I. PMID: 36317979.


Dionne JM, Bremner SA, Baygani SK, Batton B, Ergenekon E, BhattMehta V, Dempsey E, Kluckow M, Pesco Koplowitz L, ApeleFreimane D, Iwami H, Klein A, Turner M, Rabe H; International Neonatal Consortium. Method of Blood Pressure Measurement in Neonates and Infants: A Systematic Review and Analysis. J Pediatr. 2020 Jun;221:2331.e5. doi: 10.1016/j.jpeds.2020.02.072. PMID: 32446487.

St Peter D, Gandy C, Hoffman SB. Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions. Neonatology. 2017;111(3):228233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415.

Fanaroff JM, WilsonCostello DE, Newman NS, Montpetite MM, Fanaroff AA. Treated hypotension is associated with neonatal morbidity and hearing loss in extremely low birth weight infants. Pediatrics. 2006 Apr;117(4):11315. doi: 10.1542/peds.20051230. PMID: 16585307

Dempsey EM, Barrington KJ, Marlow N, O'Donnell CPF, Miletin J, Naulaers G, Cheung PY, Corcoran JD, ElKhuffash AF, Boylan GB, Livingstone V, Pons G, Macko J, Van Laere D, Wiedermannova H, Straňák Z; HIP consortium. Hypotension in Preterm Infants (HIP) randomised trial. Arch Dis Child Fetal Neonatal Ed. 2021 Jul;106(4):398403. doi: 10.1136/archdischild2020320241. Epub 2021 Feb 24. PMID: 33627329; PMCID: PMC8237176.



*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

posted by koenraada9