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1127 Measuring Blood Pressure and Managing “Hypotension” in Newborn Babies: Variation in Practices
  1. S Garg,
  2. W Tin
  1. Neonatal Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK

Abstract

Background and Aims Measuring blood pressure (BP) is an important part of cardiovascular assessment in newborns. Although arterial BP is considered as a gold standard, various methods of non-invasive BP measurements are used in clinical practice. The various studies have shown that BP measured by Doppler is better correlated with arterial BP than the oscillometric method. Regardless of definition of “hypotension”, there is no agreement on its management strategies.

The Aim of this study is to survey the variations in practices in all tertiary neonatal units across England in management of hypotension.

Methods A structured questionnaire based telephonic survey.

Results The response rate was 100% (45 units surveyed). Forty units (89%) use arterial BP and/or oscillometric method, and only 5 units (11%) use Doppler method. Twenty seven units (60%) have written guidelines on management of hypotension. Forty (90%) units use fluid bolus as the first line management; two units use fresh frozen plasma if the perfusion remains low. Thirty seven units (82%) use dopamine as the first line inotropic agent. Twenty units (45%) keep the umbilical arterial lines for as long as needed but the others keep them for different periods (3–14 days).

There are 9 different makes of oscillometric monitors used, and 10% of the units use different makes in one intensive care area.

Conclusion Marked variation remains in management of hypotension in newborn babies. There is a need to formulate evidence based guidelines for management of hypotension and to study the accuracy of non-invasive methods of BP measurement.

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