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

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.

Automated summary

The management of early hypotension in extremely low gestational age neonates varies greatly between centers. This study found that a substantial proportion of ELGANs were exposed to vasoactive medications during the first postnatal week, with slightly lower overall use in 2014-2018 compared to 2009-2013.