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![Treatment algorithm for the management of low BP in extremely preterm infants during the first 72 h of life; The HIP (hypotension in preterm infant) Trial. HIP is designed to evaluate two strategies in a randomized controlled trial, and define the efficacy of the most commonly used inotropic medication, dopamine. From Dempsey EM, et al. Neonatol 2014;105:275-81 [22].](publication/271142939/figure/fig3/AS:648940290601022@1531730830899/Treatment-algorithm-for-the-management-of-low-BP-in-extremely-preterm-infants-during-the.png)
Treatment algorithm for the management of low BP in extremely preterm infants during the first 72 h of life; The HIP (hypotension in preterm infant) Trial. HIP is designed to evaluate two strategies in a randomized controlled trial, and define the efficacy of the most commonly used inotropic medication, dopamine. From Dempsey EM, et al. Neonatol 2014;105:275-81 [22].
Source publication
Many neonatologists routinely treat infants whose mean arterial blood pressure in mm Hg is less than their gestational age in weeks (GA) but there is uncertainty regarding diagnosis and treatment of hypotension. This addresses the definition of permissive hypotension based on the principles of cardiovascular physiology, and reviews the tools availa...
Context in source publication
Context 1
... stress-velocity relationship showed a steep slope in the low ESWS range, as seen in Figure 2 15 scientists, pharmacologists and industry partners (Figure 4) to provide assessment protocols for determining when we should treat hypotension in the extremely preterm babies (< 28 weeks of gestation) and in using the most commonly used dopamine. ...
Citations
... Neonatal hypertension is identified when the systolic BP measured 3 times is higher than the 95th percentile in the BP classification by gestational age, birth weight, and sex. 6,7) The evaluation of hypotension in newborns is also important. Hypotension is identified when the systolic BP is less than the 5th-10th percentiles by gestational and postnatal age. ...
... Hypotension is identified when the systolic BP is less than the 5th-10th percentiles by gestational and postnatal age. 7) In extremely low birth weight infants, information on a normal BP is insufficient; therefore, mean arterial BP, which is lower than the newborn's gestational age in weeks, is clinically used as a treatment criterion. 7) In neonates, especially in cases of arterial catheterization through the umbilical artery, intra arterial BP through the catheter is the gold standard method for neonatal BP measurements. ...
... 7) In extremely low birth weight infants, information on a normal BP is insufficient; therefore, mean arterial BP, which is lower than the newborn's gestational age in weeks, is clinically used as a treatment criterion. 7) In neonates, especially in cases of arterial catheterization through the umbilical artery, intra arterial BP through the catheter is the gold standard method for neonatal BP measurements. 6,8) Neonatal movement, feeding, catheter position, and appropriate catheter size for the vessel Definition of hypertension in children ...
A mercury sphygmomanometer (MS) has been the gold standard for pediatric blood pressure (BP) measurements, and diagnosing hypertension is critical. However, because of environmental issues, other alternatives are needed. Non-invasive BP measurement devices are largely divided into auscultatory and oscillometric types. The aneroid sphygmomanometer, the currently used auscultatory method, is inferior to mercury sphygmomanometers in terms of limitations such as validation and regular calibration and difficult to apply to infants, in whom Korotkoff sounds are not audible. The oscillometric method uses an automatic device that eliminates errors caused by human observers and has the advantage of being easy to use; however, owing to its measurement accuracy issues, the development of an international validation protocol for children is important. The hybrid method, which combines the auscultatory and electronic methods, solves some of these problems by eliminating the observer bias of terminal digit preference while maintaining measurement accuracy; however, the auscultatory method remains limited. As the age-related characteristics of the pediatric group are heterogeneous, it is necessary to reconsider the appropriate BP measurement method suitable for this indication. In addition, the mobile application-based BP measurement market is growing rapidly with the development of smartphone applications. Although more research is still needed on their accuracy, many experts expect that mobile application-based BP measurement will effectively reduce medical costs due to increased ease of access and early BP management.
... 18) Hypotension was defined as a mean blood pressure of <30 mmHg. 19) Neutropenia was defined as a neutrophil count of <1,000/μL. 20) Respiratory distress syndrome (RDS) was limited to the cases undergoing surfactant replacement treatments. ...
Purpose:
This study was undertaken to investigate the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients.
Methods:
A retrospective analysis of the medical records was conducted in a NICU of a university hospital over a 7.5-year period (Jan 2010-Jun 2017).
Results:
During the study period, there were 45 (1.2%) episodes of EOS in 3,862 infants. The most common pathogen responsible for EOS was Streptococcus group B (GBS) in 10 cases (22.2%), followed by E. coli in 9 cases (20%). The frequency of Gram-positive sepsis was higher in term than in preterm infants, while the rate of Gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There was a significant difference in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. In a comparison after adjusting for the difference in gestational age and birth weight between the two groups, Gram-negative pathogens (OR: 42, 95% CI: 1.4~1281.8) and some clinical findings, such as neutropenia (OR: 46, 95% CI: 1.3~1628.7) and decreased activity (OR: 34, 95% CI: 1.8~633.4), were associated with fatality.
Conclusion:
The common pathogens responsible for EOS in NICU patients are GBS and E. coli. Infection caused by Gram-negative bacteria, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.
... As a rough rule of thumb, the lower limit of normal mean BP on the day of birth, in mmHg, is approximately equal to the gestational age in weeks [2]. Low BP is considered hypotension, which needs to be treated if there are other signs of insufficient cardiac output like poor skin perfusion, metabolic acidosis, anuria and so on [3][4][5]. Neonatal hypertension has been found in 0.2-2.6% of neonatal intensive care survivors [6][7][8]. As there is dearth of studies reporting BP in healthy term and preterm neonates and as both genetic and environment factors may affect BP, we considered it worthwhile to determine the BP of healthy term and preterm Indian neonates rather than simply accepting Western data. ...
Prospective observational study was conducted in a tertiary care hospital of India over 8 months to measure blood pressure (BP) in healthy term and preterm neonates using oscillometric method and explore the associations with gestational age and birth weight. Consecutive BP measurements were taken by standard oscillometric method on 1617 neonates on day 4, 7 and 14 of life. Mean birth weight was 2.7 ± 0.46 kg, and mean gestational age was 38.2 ± 2.12 weeks. The mean arterial pressure (MAP) on day 4, 7 and 14 were 59.3 ± 7.33, 63.2 ± 6.55 and 66.4 ± 6.13 mmHg, respectively. Larger and mature newborns had significantly higher BP than those who were smaller and premature. Birth weight more strongly correlated with MAP than gestational age. Predictive equations linking MAP with gestational age and birth weight were deduced, which can be used for judicious fluid inotrope management.
© The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Mobile devices, TVs, and even houses are getting the "smart" treatment, and the demand for self-monitoring is growing. The Working Group of the European Society of Hypertension evaluates blood pressure measuring equipment in order to assist consumers in making informed decisions. This is the first independent device validation report. O'Brien and colleagues, 2001.) Smart blood pressure measurement devices are costly and slow, making them unsuitable for children. Because primary hypertension is more common in adolescents, it is more difficult to obtain products. Grewal, Mattoo, and Kapur, 2023. For the Internet of Things, a smart measuring tool for children's hypertension will be developed, allowing them to live a happy life free of their parents' worry and concern. Providing an IoT-based Smart Pediatric Hypertension System in order to reduce the number of deaths caused by delayed medical attention. IoT and Arduino are used to create a device that measures high blood pressure in children. The main idea is to control conventional hypertension measurement and obstacle detection using an Arduino microcontroller, GSM/GPS tool, blood pressure sensor, IFTTT platform, and lithium batteries. By developing an Internet of Things-based intelligent pediatric hypertension solution, this project aims to provide a profitable and full-time job with respectable employment for everyone, as well as promote balanced, equitable, and sustainable economic development. Comparisons between projects have been made to make selecting the right components easier. The critical components for the IoT-based Smart Pediatric Hypertension for Children alerting System will be identified, and the circuit design will be provided. Data on a variety of issues is collected using samples from hypertensive children aged 4 to 13. To provide accurate hypertension readings, compatibility and light components are used. Wi-Fi enabled Arduino Nano bracelet with blood pressure sensor, notification feature, IFTTT platform, GSM/GPS module, Lithium Batteries, and call and message warning.
