Abstract 1265 Poster Session IV, Tuesday, 5/4 (poster 218)

To assess the comparative efficacy of NS and ALB for treatment of acute neonatal hypotension, infants weighing less than 2500 g at birth were prospectively randomized to receive either solution. Hypotension was defined as an oscillometric mean arterial blood pressure (MAP) <30 mmHg for at least 30 minutes. Successful resolution of hypotension was defined as a sustained MAP >30 mmHg for at least 30 minutes. Exclusion criteria consisted of proven sepsis, life-threatening congenital anomalies, congenital heart disease, unresolved thoracic airleak, insulin-requiring maternal diabetes mellitus, or treatment with high-frequency ventilation. Following randomization, infants were given a 10 mL/kg bolus of the assigned solution, which could be repeated a second time if the infant failed to respond. MAP was measured and recorded every 15 minutes. Twenty-four infants were randomized; there were no significant demographic differences between the two groups. Eleven infants received ALB and 13 received NS. Successful resolution of hypotension was seen in 9/11 (82%) of the ALB group and in 7/13 (54%) of the NS group. There were no statistically significant differences in response to treatment (p=0.21, Fischer's Exact Test). There were also no statistically significant differences in the magnitude of change in MAP between ALB and NS treated infants (p=0.69, Fischer's Exact Test). (Table) NS appears to be as effective as ALB in the correction of acute neonatal hypotension in infants <2500 g at birth. It is also considerably less expensive and more readily available, and it should be considered the initial treatment of choice.

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