Clinical, Infectious and Biochemical Characteristics of Arterial Hypotension in Premature Infants with Early Bacterial Infections

Background: Early onset infections play a big role in the number of adverse health effects among newborns, while their frequency is high enough. Namely hemodynamic disturbances often cause adverse events. Prediction of early neonatal sepsis in premature infants is imperfect, and pathogenetic mechanisms of hypotension syndrome and its correction – are not finally clarified.

Objective: The aim of our study was to explore the clinical, infectious and metabolic manifestations of hypotension in premature infants and to justify diagnostic algorithm for determining hypotension syndrome and indications for use of hemodynamic support in premature infants with early bacterial infections.

Methods: Prospective observational study included 118 preterm infants with early neonatal sepsis (n=57 with arterial hypotension and n=61 without arterial hypotension) admitted to the neonatal intensive care units of children’s hospitals of Poltava region.

Results: In premature infants with hypotension compared with children without hypotension, there are significantly lower average values of SILV (stroke index of left ventricle) (р=0,005), IR ACM (р=0,012), pH (p=0,05), and significantly higher levels of urea (p=0,002) in blood serum and more specific percentage of children with hypoglycemia (p=0,013). Operating characteristics of predictive model that includes SILV, pH, glucose

Conclusions: Our results were the basis for the definition of "hypotension syndrome", which includes the mean blood pressure of a child in mm less than gestational age in weeks and the presence of SILV less than the age limit, pH less than 7,2, blood glucose less than 2.8 mmol/l and it can serve as a demonstration to the purpose of drug hemodynamic support, unlike the current situation where it is prescribed only under reduced pressure, which in premature infants may not be accompanied by adverse changes in organs and systems.