ABSTRACT

The diagnosis and treatment of hypotension in the sick neonate is a controversial area. Treatment decisions are based on statistically defined gestational and postnatal age-dependent normative blood-pressure values, combined with clinical intuition, due to difficulties evaluating organ perfusion and adequacy of cerebral oxygen delivery. Volume administration is the primary initial therapy in early-onset hypotension. However, its use can be associated with significant hazardous effects, especially in preterm infants, and should be limited to 10-20 mL/kg of isotonic saline. If the blood pressure cannot be normalized, dopamine should be added, and sometimes followed by adrenaline (epinephrine) and corticosteroids.