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Vasoactive medications in extremely low gestational age neonates during the first postnatal week

Journal of Perinatology volume 41, pages 2330–2336 (2021)Cite this article

Subjects

Abstract

Objective

The management of early hypotension in extremely low gestational age neonates (ELGANs) varies greatly between centers. The objective of this study was to provide updated data on the use of vasoactive medications in ELGANs during the first postnatal week.

Study design

We identified ELGANs (22–27 weeks gestational age) cared for at Pediatrix neonatal intensive care units from 2009 to 2018. We evaluated the frequency of exposure to vasoactive medications by gestational age, and compared use of vasoactive medications between two epochs (2009–2013 and 2014–2018).

Results

A total of 10,070/34,234 (29%) ELGANs received ≥1 vasoactive medication. Dopamine was the most frequently used vasoactive medication. The majority (83%) of treated ELGANs initiated therapy on postnatal days 0–1. Overall use of vasoactive medications was slightly lower in 2014–2018 than 2009–2013 (28 vs 31%, p < 0.001).

Conclusion

A substantial proportion of ELGANs were exposed to vasoactive medications during the first postnatal week.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA

    Laura E. Miller, Kanecia O. Zimmerman, Christoph P. Hornik, Samia Aleem, P. Brian Smith & Rachel G. Greenberg

  2. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Matthew M. Laughon

  3. MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, FL, USA

    Reese H. Clark

  4. Duke Clinical Research Institute, Durham, NC, USA

    Kanecia O. Zimmerman, Christoph P. Hornik, Samia Aleem, P. Brian Smith & Rachel G. Greenberg

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  1. Laura E. Miller
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Contributions

All authors were involved in the study design, analysis, and manuscript revision. All authors read and approved the final manuscript. LEM is the guarantor who accepts full responsibility for the work and the conduct of the study, has access to the data, and controlled the decision to publish. LEM: contributed to the conception and design of the study, the data interpretation, the manuscript drafting, and the critical revision of the manuscript. MML, KOZ, CPH, SA, and PBS: contributed to the conception and design of the study, the data interpretation, and the critical revision of the manuscript. RHC: contributed to the conception and design of the study, the data acquisition, the data interpretation, and the critical revision of the manuscript. RGG: had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; contributed to the conception and design of the study, the data interpretation, the manuscript drafting, and the critical revision of the manuscript.

Corresponding author

Correspondence to Rachel G. Greenberg.

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Miller, L.E., Laughon, M.M., Clark, R.H. et al. Vasoactive medications in extremely low gestational age neonates during the first postnatal week. J Perinatol 41, 2330–2336 (2021). https://doi.org/10.1038/s41372-021-01031-8

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  • DOI: https://doi.org/10.1038/s41372-021-01031-8

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