Introduction Hypotension of the premature newborn is a condition commonly encountered in the neonatal intensive care setting. Although no definite cut-off values exist in considering a given newborn to be hypotensive, certain blood pressure ranges will cause significant anxiety among…
Key points Although there is no consensus on the definition of hypotension in preterm infants, up to 50% of very low birth weight (VLBW) infants are diagnosed with hypotension, and about one-third of extremely preterm infants receive at least one…
Key points Sepsis can progress rapidly from mild clinical signs to full-blown septic shock with high morbidity and mortality. The clinical recognition of the onset of sepsis and the onset of neonatal septic shock can be challenging. In conjunction with…
Key points The very-low-birth-weight infant is hemodynamically vulnerable due to a unique set of risk factors, which include an immature myocardium with poor response to volume load and afterload, immature autonomic vasoregulation, and thus ineffective cardiovascular compensatory mechanisms, a propensity…
Key points Accurate assessment of the hemodynamic status in critically ill neonates requires blood pressure measurements to be interpreted in the context of indirect (clinical signs) and direct (measurements and assessments) indicators of systemic circulation (cardiac output) and regional organ…
Key points A period of systemic and cerebral hypoperfusion in the immediate postnatal period predisposes the extremely preterm infant to peri-/intraventricular hemorrhage (P/IVH). Cardiovascular immaturity and maladaptation after birth contribute to postnatal hypoperfusion. Ventilatory support, especially inappropriately high mean airway…
Key points In the context of neonatal care, invasive or noninvasive measurement of blood pressure can be accomplished with acceptable precision across all gestational age categories. Gestational and postnatal-age-dependent population-based normative blood pressure ranges are available. However, their usefulness in…
Key points 1. A successful hemodynamic transition from fetal to extrauterine life is a complex process and requires the interdependent sequential physiologic changes to take place in a timely manner 2. Immaturity- or pathophysiology-driven disturbances of the transitional process may…
Introduction Cardiovascular compromise in the fetus and neonate often leads to severe organ injury or death, and the success of therapeutic interventions is limited by difficulties with accurate and timely detection of the condition, especially in the fetus, and the…
Introduction The majority of the existing information on the regulation of acid-base homeostasis in mammals and humans was obtained from studies in adult subjects. Revolution in micromethodology and advances in developmental physiology and molecular biology provided additional insights and improved…