Blood Pressure Goals: Is Cerebral Saturation the New Mean Arterial Pressure?
Am J Perinatol
; 2022 Jan 18.
Article
en En
| MEDLINE
| ID: mdl-34814195
ABSTRACT
OBJECTIVE:
The objective of this article was to correlate hypotension and cerebral saturation from near-infrared spectroscopy (cNIRS) in neonates on dopamine. STUDYDESIGN:
Retrospective review of neonates receiving dopamine between August 2018 and 2019 was performed. Hypotension thresholds included mean arterial pressure (MAP) of postmenstrual age (PMA) ± 5 and 30 mm Hg and gestational age (GA) ± 5 mm Hg. Time below threshold MAP was compared with time with cerebral hypoxia (cNIRS <55%).RESULTS:
Hypotension occurred 6 to 33% of the time on dopamine in 59 cases. Hypotension did not correlate with abnormal cNIRS overall, within PMA subgroups or by outcomes. Hypotensive periods with MAP < GA had fewer corresponding percent time with abnormal cNIRS events (3.7 ± 1.3%) compared with MAP < PMA (11.9 ± 4.9%, p < 0.003) or 30 mm Hg thresholds (12.2 ± 4.7%, p < 0.0001). In most premature infants, mean cNIRS values during hypotension were still within normal range (57 ± 6%).CONCLUSION:
cNIRS may be a more clinically relevant measure than MAP for the assessment of neonatal hypotension. KEY POINTS · Hypotension occurred 6 to 33% of the time on dopamine in 59 cases.. · Hypotension did not correlate with abnormal cNIRS overall, within PMA subgroups or by outcomes.. · MAP. · We found no cNIRS difference between IVH grades, mortality, average Hct, lactates, or urine output.. · cNIRS may be a more clinically relevant measure than MAP for the assessment of neonatal hypotension..
Texto completo:
1
Banco de datos:
MEDLINE
Idioma:
En
Revista:
Am J Perinatol
Año:
2022
Tipo del documento:
Article