Management of Hypotension in Preterm Infants (The HIP Trial): A Randomised Controlled Trial of Hypotension Management in Extremely Low Gestational Age Newborns

Background: Extremely preterm babies (delivered at <28 completed weeks of gestation) are frequently diagnosed with hypotension and treated with inotropic and pressor drugs in the immediate postnatal period. Dopamine is the most commonly used first-line drug. Babies who are treated for hypotension more frequently sustain brain injury, have long-term disability or die compared to those who are not. Despite the widespread use of drugs to treat hypotension in such infants, evidence for efficacy is lacking, and the effect of these agents on long-term outcomes is unknown. Hypothesis: In extremely preterm babies, restricting the use of dopamine when mean blood pressure (BP) values fall below a nominal threshold and using clinical criteria to determine escalation of support (‘restricted’ approach) will result in imReceived: August 15, 2013 Accepted after revision: November 24, 2013 Published online: February 27, 2014 Eugene Dempsey Neonatal Intensive Care Unit Department of Paediatrics and Child Health University College Cork, Cork (Ireland) E-Mail gene.dempsey @ hse.ie © 2014 S. Karger AG, Basel 1661–7800/14/1054–0275$39.50/0 www.karger.com/neo HIP Collaborators: Dr. Brendan Murphy, Prof. Cornelius Anthony Ryan, Prof. Geraldine Boylan, Prof. Naomi McCallion, Dr. Afif EL-Khuffash, Dr. Liesbeth Thewissen, Dr. Jana Semberová, Patrick Chevarier . Th is is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. D ow nl oa de d by : 54 .1 91 .4 0. 80 9 /1 7/ 20 17 1 :2 2: 23 A M