4 *MYTHS* about Newborn Blood Pressure!! And why they're WRONG!!
4.9 هزار بار بازدید -
3 ماه پیش
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Inotropes? Vasopressors? Why do we
Inotropes? Vasopressors? Why do we even CARE about BPs? What about Oxygenation status? What is a LOW blood pressure in a baby? Do we just care about the MEAN BP? Or systolic and diastolic BPs too? How should we treat hypotension? Should we always treat low BPs?
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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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):174-88. doi: 10.1053/j.semperi.2015.12.005. Epub 2016 Jan 14. PMID: 26778235.
Mullaly R, El-Khuffash AF. Haemodynamic assessment and management of hypotension in the preterm. Arch Dis Child Fetal Neonatal Ed. 2024 Feb 19;109(2):120-127. doi: 10.1136/archdischild-2022-324935. PMID: 37173119.
Dionne JM, Bremner SA, Baygani SK, Batton B, Ergenekon E, Bhatt-Mehta V, Dempsey E, Kluckow M, Pesco Koplowitz L, Apele-Freimane 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;221:23-31.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):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415.
Fanaroff JM, Wilson-Costello 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):1131-5. doi: 10.1542/peds.2005-1230. PMID: 16585307
Dempsey EM, Barrington KJ, Marlow N, O'Donnell CPF, Miletin J, Naulaers G, Cheung PY, Corcoran JD, El-Khuffash 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):398-403. doi: 10.1136/archdischild-2020-320241. Epub 2021 Feb 24. PMID: 33627329; PMCID: PMC8237176.
Faust K, Härtel C, Preuß M, Rabe H, Roll C, Emeis M, Wieg C, Szabo M, Herting E, Göpel W; Neocirculation project and the German Neonatal Network (GNN). Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life. Arch Dis Child Fetal Neonatal Ed. 2015 Sep;100(5):F388-92. doi: 10.1136/archdischild-2014-306483. Epub 2015 Jul 21. PMID: 26199082.
St Peter D, Gandy C, Hoffman SB. Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions. Neonatology. 2017;111(3):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415
Kluckow M, Evans N. Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F188-94. doi: 10.1136/fn.82.3.f188. PMID: 10794784; PMCID: PMC1721081.
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**TIMESTAMPS**
01:03 MYTH #1: 'Vasopressor' and 'Inotrope' mean same thing
05:23 Myth # 2: A blood pressure is a good indicator of a baby's Oxygenation status
11:04 Myth # 3: Mean BP is most important indicator of status
16:22 Myth # 4: Routinely treating hypotension in neonates improves outcomes
-----------------------------------------------------------------------------
*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.
Sign up for our newsletter and receive 50 neonatal multiple choice questions immediately! We also include a PDF summary of our most recent video! Join us here: https://talatalksnicu.substack.com/su...
---------------------------------------------------------------------
Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded!
---------------------------------------------------------------------
Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 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):174-88. doi: 10.1053/j.semperi.2015.12.005. Epub 2016 Jan 14. PMID: 26778235.
Mullaly R, El-Khuffash AF. Haemodynamic assessment and management of hypotension in the preterm. Arch Dis Child Fetal Neonatal Ed. 2024 Feb 19;109(2):120-127. doi: 10.1136/archdischild-2022-324935. PMID: 37173119.
Dionne JM, Bremner SA, Baygani SK, Batton B, Ergenekon E, Bhatt-Mehta V, Dempsey E, Kluckow M, Pesco Koplowitz L, Apele-Freimane 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;221:23-31.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):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415.
Fanaroff JM, Wilson-Costello 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):1131-5. doi: 10.1542/peds.2005-1230. PMID: 16585307
Dempsey EM, Barrington KJ, Marlow N, O'Donnell CPF, Miletin J, Naulaers G, Cheung PY, Corcoran JD, El-Khuffash 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):398-403. doi: 10.1136/archdischild-2020-320241. Epub 2021 Feb 24. PMID: 33627329; PMCID: PMC8237176.
Faust K, Härtel C, Preuß M, Rabe H, Roll C, Emeis M, Wieg C, Szabo M, Herting E, Göpel W; Neocirculation project and the German Neonatal Network (GNN). Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life. Arch Dis Child Fetal Neonatal Ed. 2015 Sep;100(5):F388-92. doi: 10.1136/archdischild-2014-306483. Epub 2015 Jul 21. PMID: 26199082.
St Peter D, Gandy C, Hoffman SB. Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions. Neonatology. 2017;111(3):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415
Kluckow M, Evans N. Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F188-94. doi: 10.1136/fn.82.3.f188. PMID: 10794784; PMCID: PMC1721081.
----------------------------------------------------------------------------
**TIMESTAMPS**
01:03 MYTH #1: 'Vasopressor' and 'Inotrope' mean same thing
05:23 Myth # 2: A blood pressure is a good indicator of a baby's Oxygenation status
11:04 Myth # 3: Mean BP is most important indicator of status
16:22 Myth # 4: Routinely treating hypotension in neonates improves outcomes
-----------------------------------------------------------------------------
*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.
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