Abstract
Objective The objective of this article was to correlate hypotension and cerebral saturation
from near-infrared spectroscopy (cNIRS) in neonates on dopamine.
Study Design Retrospective review of neonates receiving dopamine between August 2018 and 2019
was performed. Hypotension thresholds included mean arterial pressure (MAP) of postmenstrual
age (PMA) ± 5 and 30 mm Hg and gestational age (GA) ± 5 mm Hg. Time below threshold
MAP was compared with time with cerebral hypoxia (cNIRS <55%).
Results Hypotension occurred 6 to 33% of the time on dopamine in 59 cases. Hypotension did
not correlate with abnormal cNIRS overall, within PMA subgroups or by outcomes. Hypotensive
periods with MAP < GA had fewer corresponding percent time with abnormal cNIRS events
(3.7 ± 1.3%) compared with MAP < PMA (11.9 ± 4.9%, p < 0.003) or 30 mm Hg thresholds (12.2 ± 4.7%, p < 0.0001). In most premature infants, mean cNIRS values during hypotension were still
within normal range (57 ± 6%).
Conclusion cNIRS may be a more clinically relevant measure than MAP for the assessment of neonatal
hypotension.
Key Points
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Hypotension occurred 6 to 33% of the time on dopamine in 59 cases.
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Hypotension did not correlate with abnormal cNIRS overall, within PMA subgroups or
by outcomes.
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MAP
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We found no cNIRS difference between IVH grades, mortality, average Hct, lactates,
or urine output.
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cNIRS may be a more clinically relevant measure than MAP for the assessment of neonatal
hypotension.
Keywords
Blood pressure - Neonates - Hypotension - NIRS
