Management of hypotension in the very low-birth-weight infant during the golden hour.

Primum non nocere, a saying in Latin that means "first, do no harm," is a phrase neonatal clinicians should keep in mind when initiating or suggesting treatment. In the "golden hour" of resuscitation of the very low-birth-weight infant, team members assess multiple parameters of the infant's vital signs, with a key one being that of the cardiovascular status, specifically blood pressure. Attempts to treat a number rather than after assessment and develop a sound plan of care based on findings, will affect both short- and long-term outcomes. By understanding what neonatal hypotension is and knowing when and how to treat it, the neonatal clinician honors this charge and can safely and effectively manage the very low-birth-weight infant with hypotension shortly after birth.