Neonatal Hypotension Defined: How Low Is Too Low for a Premature Baby?
When is blood pressure too low in a newborn? How do we define neonatal hypotension, especially in extremely premature babies?
In this video, Dr. Tala, a board-certified neonatologist, explains how blood pressure is measured in neonates and why defining hypotension in premature infants is much more complicated than using a single blood pressure number.
Watch Part 1 here: https://youtu.be/A1Ffbzf6iRM
If you work in neonatology, pediatrics, NICU care, or are studying neonatal physiology, this video provides an important foundation for understanding how to evaluate low blood pressure in newborns.
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'Osteopenia of Prematurity' or 'Rickets of Prematurity' or Metabolic Bone Disease all refer to the same process: premature babies developing weak bones because it's so hard to feed a baby enough calcium and phosphorous. Watch this video to learn about the risk factors, the causes, and the general incidence of MBD.
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 18 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Peripheral Arterial Line (PAL): https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/peripheral-arterial-access-in-neonates-requiring-intensive-care
Digit ischemia and necrosis after PAL cannulation: https://www.researchgate.net/figure/Resolving-ischemia-of-the-2nd-3rd-4th-and-5th-fingers-5-days-after-the-ischemic-event_fig3_258704424
Miall-Allen VM, de Vries LS, Whitelaw AG. Mean arterial blood pressure and neonatal cerebral lesions. Arch Dis Child. 1987 Oct;62(10):1068-9. doi: 10.1136/adc.62.10.1068. PMID: 3314723; PMCID: PMC1778679.
Dionne, Janis M., Stephen A. Bremner, Simin K. Baygani, Beau Batton, Ebru Ergenekon, Varsha Bhatt-Mehta, Eugene Dempsey et al. "Method of blood pressure measurement in neonates and infants: a systematic review and analysis." The Journal of pediatrics 221 (2020): 23-31.
Under auto-regulation: https://www.physio-pedia.com/Vasodilators
Elsayed, Y., Ahmed, F. Blood pressure normative values in preterm infants during postnatal transition. Pediatr Res 95, 698–704 (2024). https://doi.org/10.1038/s41390-023-02788-8
Kluckow M, Evans N. Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F188-94. doi: 10.1136/fn.82.3.f188. PMID: 10794784; PMCID: PMC1721081.
Rhee, C.J., da Costa, C.S., Austin, T. et al. Neonatal cerebrovascular autoregulation. Pediatr Res 84, 602–610 (2018). https://doi.org/10.1038/s41390-018-0141-6
Fluid Therapy During Cardiopulmonary Resuscitation - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Oxygen-delivery-to-the-tissues-DO2-is-the-product-of-cardiac-output-CO-the-volume-of_fig1_348842167
Mean Arterial Pressure is the average arterial pressure of a patient: https://clinicalview.gehealthcare.com/white-paper/measuring-mean-arterial-pressure-choosing-most-accurate-method
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***TIMESTAMPS***
00:00 Introduction
00:38 How Is Blood Pressure Measured in Neonates?
05:53 How Is Neonatal Hypotension Defined?
17:25 Final Message
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*Disclaimer*: This video is intended for educational purposes only, and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.
#nicu #neonatalresuscitation #nicunurse #neonatology #neonatalhypotension