Evaluation and Treatment of Hypotension in the Preterm Infant
Evaluation and Treatment of Hypotension in the Preterm Infant
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DOI：
10.1016/j.clp.2008.09.003
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发表时间：
2009-03-01
影响因子：
2.1
通讯作者：
Barrington, K. J.
中科院分区：
文献类型：
--
作者：
Dempsey, E. M.;Barrington, K. J.
很大一部分极早产儿接受低血压治疗。低血压的定义是不明确的，而且，目前，没有证据表明治疗它可以改善结果，或者，实际上，在可用的替代方案中选择哪种治疗方法。评估早产儿的循环充分性需要仔细的临床评估，也可能需要辅助调查。最常用的干预措施，液体丸和多巴胺，是有问题的：从统计数据来看，液体丸与较差的临床结果相关，甚至可能不会升高血压，而多巴胺主要通过引起血管收缩而升高血压，并可能减少灌注。对于这两种干预都没有任何可靠的数据显示临床益处。目前迫切需要干预低血压和循环系统损害的前瞻性试验。
A large proportion of very preterm infants receive treatment for hypotension. The definition of hypotension is unclear, and, currently, there is no evidence that treating it improves outcomes or, indeed, which treatment to choose among the available alternatives. Assessment of circulatory adequacy of the preterm infant requires a careful clinical assessment and may also require ancillary investigations. The most commonly used interventions, fluid boluses and dopamine, are problematic: fluid boluses are statistically associated with worse clinical outcomes and may not even increase blood pressure, whereas dopamine increases blood pressure mostly by causing vasoconstriction and may decrease perfusion. For neither intervention is there any reliable data showing clinical benefit. Prospective trials of intervention for hypotension and circulatory compromise are urgently required.