Blood pressure

Published on 03/06/2015 by admin

Filed under Neonatal - Perinatal Medicine

Last modified 22/04/2025

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CHAPTER 9 Blood pressure

Mark Davies

Reference values

Some reference values for blood pressure are given below. These values are a guide only. The adequacy of an individual infant’s blood pressure (BP) and the possible need for treatment should be based on clinical factors (e.g. peripheral perfusion, urine output, BP waveform, metabolic acidosis) in addition to these values.

Mean arterial blood pressure

Table 9.1 Lower 95% CI for mean arterial blood pressure (mmHg) in VLBW infants

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Systolic blood pressure

Table 9.2 Systolic BP (mmHg): age 4–24 hours

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Table 9.3 Systolic BP (mmHg): age 10 days

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Treatment options

Low BP in a newborn infant may be due to a number of factors including hypovolaemia, myocardial insufficiency, low peripheral vascular resistance, patent ductus arteriosus or any combination of these.

• If hypovolaemia is suspected it is reasonable to give 1–2 doses of 10 mL/kg Nsaline (Normal saline, 0.9%); or in some units colloid, e.g. albumin.

— If there is no response after 2 doses of plasma expanders then inotropes are usually considered as the next option (unless the baby is still considered to be hypovolaemic).
— Use dobutamine if myocardial insufficiency is suspected, and dopamine if low peripheral vascular resistance is suspected.

• Recalcitrant hypotension can be treated with steroids:

— hydrocortisone IV: 2.5 mg/kg 4 hourly initially; or
— dexamethasone IV: 0.25 mg/kg.

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