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Pediatric Congress 2019 Current Pediatric Research | ISSN: 0971-9032 | Volume 23
Page 26
July 25-26, 2019 | Amsterdam, Netherlands
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
International Conference on
PEDIATRICS AND NEONATOLOGY
CURRENT TREATMENT OF HYPOTENSION
IN ELBW INFANTS: COMPLICATIONS AND
CONTROVERSIES
Introduction: Early postnatal hypotension (EPH) in premature infants is
treated with vasopressor-inotropes (VI) in escalating doses, followed by hy-
drocortisone (HC) if VI therapy fails. There is no report on the adverse effects
of this standard clinical practice.
Objective: To investigate the complications associated with the escalating
treatments of hypotension with sequential inotropes and hydrocortisone in
ELBW neonates.
Methodology: In a retrospective case-control study the complications and
adverse outcomes associated with VI (VI) and HC (HCVI) treatments were
compared with contemporaneous normotensive medication naïve controls
(C) via standard univariate and multivariate analyses.
Results: VI (n=74) Vs C (n=124): Birth weight (BW), gestational age (GA) and
receipt of antenatal steroid (ANS) did not differ. The occurrence of gestation
associated diabetes mellitus (GDM) and risks for patent ductus arteriosus
(PDA), intraventricular-periventricular haemorrhage (IVH), spontaneous in-
testinal perforation (SIP), ventriculomegaly (VM) and oxygen dependence at
36 postmenstrual week of life (BPD) were higher in VI group. HCVI (n=69) Vs
C: HCVI recipients had lower BW, GA and receipt of ANS. The risks for IVH, BPD,
air leaks and PDA were higher in the treated infants. The occurrences of SIP,
VM and GDM did not differ while that of maternal hypertension trended to
be less in HCIV recipients (p = 0.06).
Conclusions: Hypotensive ELBW infants treated with vasopressor-inotropes
or with hydrocortisone-vasopressor-inotropes are susceptible to IVH, BPD
and PDA. Those who receive inotropes are at additional risks for SIP and VM.
GDM increases the occurrence of hypotensionwhich responds toVI and does
not need HC. Maternal hypertension does not contribute to VI responsive
and trends to decreases VI refractory hypotension.
Rita P Verma, Curr Pediatr Res 2019, Volume 23
Rita P Verma did her residency in Pediatrics, State
University of New York Hospital and School of
Medicine, Syracuse NY; Fellowship in Neona-
tal-perinatal Medicine: University of Illinois Hos-
pital and School of Medicine Chicago, IL; Board
certification: Pediatrics, Neonatal-perinatal
medicine; Specialty: Neonatal–perinatal Medi-
cine. She is Professor of Clinical Pediatrics. She
attended as a Neonatologist. She is Director of
Research, Department of Pediatrics. Her area of
research interest mostly is in extremely low birth
weight neonates, fluid and electrolyte manage-
ment, hypotension, placental histopathology
bio sketch. She worked at the State University of
NewYork Hospital and School of Medicine, Stony
Brook and the University of Maryland Hospital
and School of Medicine, Baltimore as Associate
Professor of Pediatrics before joining Nassau Uni-
versity Medical Center. She has published over
110 peer reviewed manuscripts and abstracts
and has presented results of her research at vari-
ous national and international meetings.
Rita P Verma
Nassau University Medical Center, USA
BIOGRAPHY