Abstention or intervention for isolated hypotension in the first 3 days of life in extremely preterm infants: association with short-term outcomes in the EPIPAGE 2 cohort study

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Abstract

Objective

To compare outcomes at hospital discharge for preterm infants born before 29 weeks of gestation who had at least one episode of isolated hypotension during their first 72 hours of life for which they did or did not receive antihypotensive treatment.

Design

Etude Epidémiologique sur les Petits Ages Gestationnels 2 (EPIPAGE 2) French national prospective population-based cohort study in 2011.

Setting

60 neonatal intensive care units.

Patients

All infants with a minimum mean arterial blood pressure less than gestational age (in weeks) (minMAPTreatments

Fluid bolus and/or inotropes and/or corticosteroids.

Main outcomes and measures

The primary outcome was survival at hospital discharge without major morbidity, defined as any of necrotising enterocolitis, severe cerebral abnormalities, severe bronchopulmonary dysplasia or severe retinopathy of prematurity.

Results

Among the 1532 infants with available data, 662 had a minMAPConclusions

In this population, antihypotensive treatment was associated with improved short-term outcomes. Therapeutic abstention should be cautiously considered for early isolated hypotension in extremely premature infants.

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