TREATMENT OF ARTERIAL HYPOTENSION IN NEWBORNS WITH EXTREMELY LOW GESTATIONAL AGE (LECTURE)

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Abstract

The article explores modern ideas of how to manage premature newborns with arterial hypertension. In this population of patients, hypotension with the level of the mean blood pressure below the gestational age is considered prognostically unfavourable. Standard therapy includes volemic bolus with NaCl 0.9% and inotropic support (more frequently represented by dopamin to 10 µg/kg/min). Analysis of modern literature shows that the approach is not always successful. Arterial hypotension proper must not be the reason for therapy initiation as parallel analysis of clinical and echocardiographic signs is necessary.

Echocardiography aims at the evaluation of contractility of the myocardium and systemic blood flow and exclusion of hemodynamically significant arterial duct and pulmonary hypertension. Volemic bolus is given upon respective indications and dobutamine can be considered as the 1st line inotropic agent in the majority of cases. Early administration of hydrocortisone is reasonable in resistant hypotension.

About the authors

O. E. Mitkinov

Republican Perinatal Center

Author for correspondence.
Email: moe.68@mail.ru
Ulan-Ude, Buryatia Россия

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