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  • Letter to the Editor
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Response to Dr Ghirardello

Journal of Perinatology volume 28, page 586 (2008)Cite this article

We appreciate the writer's interest and comments regarding our study. As our paper explains, our study was designed to reflect the common clinical practice of treating hypotension with judicious fluid therapy, and then pressor therapy for the non-responders.1 Many questions still exist about the criteria for the diagnosis and treatment of hypotension (that is, different blood pressure charts and different choice of pressor agents).

The writer's comment that the study was not powered to look at intraventricular hemorrhage (IVH) is certainly true. We agree that to observe a difference in IVH between two therapies would involve many thousands of babies. Our study was not designed to look at IVH as a primary outcome measure. These were secondary measures, recorded in terms of standard therapy for low-birth-weight infants. As stated in our paper, the results were compared with IVH and high-grade IVH rates from our own neonatal intensive care unit during the period of study. We agree that IVH is multifactorial, and has been shown to be associated with, but not necessarily the result of, many risk factors.

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References

  1. Lynch SK, Mullett MD, Graeber JE, Polak MJ . A comparison of an albumin–bolus therapy versus normal saline–bolus therapy for hypotension in neonates. J Perinatol 2008; 28: 29–33.

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  2. Osborn DA, Evans N, Kluckow M . Randomized trial of dobutamine versus dopamine in preterm infants with low systemic blood flow. J Pediatrics 2002; 140: 183–191.

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Authors and Affiliations

  1. Department of Pediatrics, West Virginia University, WV, USA. E-mail: slynch@hsc.wvu.edu,

    S K Lynch & M J Polak

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  1. S K Lynch
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  2. M J Polak
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Lynch, S., Polak, M. Response to Dr Ghirardello. J Perinatol 28, 586 (2008). https://doi.org/10.1038/jp.2008.82

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