Avoiding Arterial Hypotension in Preterm Neonates (AHIP)-A Single Center Randomised Controlled Study Investigating Simultaneous Near Infrared Spectroscopy Measurements of Cerebral and Peripheral Regional Tissue Oxygenation and Dedicated Interventions.

摘要: Introduction: Up to 50% of preterm infants admitted intensive care units require cardio-circulatory support. The aim the present study was assess whether simultaneous monitoring cerebral (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension catecholamine administration neonates. Study design: Preterm neonates <37 weeks gestation were included a single center randomised controlled study. Blood pressure measured non-invasively or invasively. In NIRS group cTOI pTOI used starting within six hours after birth for 24 calculate changes cTOI/pTOI ratio over time. Depending on these changes, interventions including echocardiography, volume patent ductus arteriosus (PDA) treatment performed. control group, only routine performed signals not visible. primary outcome burden 48 initiation monitoring. Results: 49 each group: 33.1 (32.0–34.0) [Median: 25-75 centile] 33.4 (32.3–34.3) gestation. echocardiography 17 due measurements, whereby received further treatment. Percentage any hypotensive episode during 48-hours observational period 32.6% 44.9% (p=0.214). Burden (i.e. %mmHg mean < gestational age) 0.0 (0.0–2.1) mmHg-hours 0.4 (0.0–3.3) (p=0.313), observed being low both groups. No severe adverse reactions observed. Conclusion: measurements early detection centralisation followed by predefined led non-significant reduction hypotension. ClinicalTrials.gov Identifier: NCT01910467