Get the LOW Down on Neonatal Hypotension
- Duration: 60 Mins
- Credits: 1 CERP, 1 R-CERP, 1 Nurse Contact Hours, 1 CME
- Handout: Yes
Abstract:
At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock.
Learning Objectives:
1. Define hypotension and explore common modalities for determining expected blood pressure depending on degree of prematurity.
2. Describe the pathophysiology and causes of hypotension.
3. Explain mechanisms of action of commonly utilized inotropic and vasopressor medications for the treatment of hypotension and shock.
