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Reply to Sehgal and Ramsden

Journal of Perinatology volume 28, page 168 (2008)Cite this article

We thank Drs Sehgal and Ramsden for their interest in our review. It was not our intention to address the theoretical basis for attempts to control blood pressure but to review the evidence regarding clinical efficacy. The authors are correct in saying that the effects on cerebral perfusion of administered therapies for hypotension may be important, but these effects are almost completely unstudied. Our own research suggests that some hypotensive, very preterm babies can still autoregulate and probably others cannot; however how this can be determined in clinical practice, and how this should affect treatment decisions, is unknown.1

Alterations in loading conditions of the heart and how they impact cardiac performance are also important issues outside the scope of our systematic review, but we agree that further afterloading of an already compromised myocardium is unlikely to be beneficial to its performance.

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References

  1. Dempsey EM, De Smet D, Naulaers G, Vanderhaegen J, Van Huffel S, Kokottis T et al. Do extreme premature infants have intact cerebral autoregulation? PAS Meeting 2007; Toronto, Canada: 8436.5.

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  1. Departments of Pediatrics, KJ Barrington, Obstetrics and Gynaecology, Royal Victoria Hospital, McGill University, Montreal, QC, Canada. E-mail: keith.barrington@mcgill.ca,

    K J Barrington

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  1. K J Barrington
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Barrington, K. Reply to Sehgal and Ramsden. J Perinatol 28, 168 (2008). https://doi.org/10.1038/sj.jp.7211884

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