Inotropes for preterm infants: fifty years on are we any wiser?

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dc.contributor.author Garvey, Aisling A.
dc.contributor.author Kooi, Elisabeth M. W.
dc.contributor.author Dempsey, Eugene M.
dc.date.accessioned 2018-05-02T10:16:29Z
dc.date.available 2018-05-02T10:16:29Z
dc.date.issued 2018
dc.identifier.citation Garvey, A. A., Kooi, E. M. W. and Dempsey, E. M. (2018) 'Inotropes for preterm infants: fifty years on are we any wiser?', Frontiers in Pediatrics, 6, 88 (7pp). doi: 10.3389/fped.2018.00088 en
dc.identifier.volume 6
dc.identifier.startpage 1
dc.identifier.endpage 7
dc.identifier.issn 2296-2360
dc.identifier.uri http://hdl.handle.net/10468/5960
dc.identifier.doi 10.3389/fped.2018.00088
dc.description.abstract For almost half a century, inotropes have been administered to preterm infants with the ultimate goal of increasing their blood pressure. A number of trials, the majority of which focused on dopamine administration, have demonstrated increased blood pressure following inotrope administration in preterm infants and have led to continued use of inotropes in our neonatal units. We have also seen an increase in the number of potential agents available to the clinician. However, we now know that hypotension is a much broader concept than blood pressure alone, and our aim should instead be focused on improving end organ perfusion, specifically cerebral perfusion. Only a limited number of studies have incorporated the organ-relevant hemodynamic changes and long-term outcomes when assessing inotropic effects in neonates, the majority of which are observational studies or have a small sample size. In addition, important considerations, including the developing/maturing adrenergic receptors, polymorphisms of these receptors, and other differences in the pharmacokinetics and pharmacodynamics of preterm infants, are only recently being recognized. Certainly, there remains huge variation in practice. The lack of well-conducted randomized controlled trials addressing these relevant outcomes, along with the difficulty executing such RCTs, leaves us with more questions than answers. This review provides an overview of the various inotropic agents currently being used in the care of preterm infants, with a particular focus on their organ/cerebral hemodynamic effects both during and after transition. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Frontiers Media SA en
dc.relation.uri https://www.frontiersin.org/articles/10.3389/fped.2018.00088/full
dc.rights © 2018, Garvey, Kooi and Dempsey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject Neonatology en
dc.subject Hypotension en
dc.subject Inotropes en
dc.subject Preterm infants en
dc.subject Blood pressure en
dc.subject End organ perfusion en
dc.title Inotropes for preterm infants: fifty years on are we any wiser? en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Eugene Dempsey, Paediatrics & Child Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: g.dempsey@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Seventh Framework Programme
dc.contributor.funder Science Foundation Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle Frontiers in Pediatrics en
dc.internal.IRISemailaddress g.dempsey@ucc.ie en
dc.identifier.articleid 88
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/260777/EU/Management of Hypotension In the Preterm Extremely Low Gestational Age Newborn/THE HIP TRIAL


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© 2018, Garvey, Kooi and Dempsey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Except where otherwise noted, this item's license is described as © 2018, Garvey, Kooi and Dempsey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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