Kalish Brian T
Neonatal Netw. 2017 Jan 1;36(1):40-47. doi: 10.1891/0730-0832.36.1.40.
Hypotension is a common problem in neonates with complex underlying pathophysiology. Although treatment of low blood pressure is common, clinicians must use all available information to target neonates with compromised perfusion. Pharmacotherapy should be tailored to the specific physiologic perturbations of the individual neonate. Dopamine is the most commonly utilized agent and may be the most appropriate agent for septic shock with low diastolic blood pressure. However, alternative therapies should be considered for other etiologies of hypotension, including milrinone and vasopressin for persistent pulmonary hypertension of the newborn and dobutamine for patent ductus arteriosus. Additional studies are required to refine the approach to neonatal hypotension and document the long-term outcomes of treated neonates.
低血压是患有复杂潜在病理生理学的新生儿中的常见问题。虽然低血压的治疗很常见，但临床医生必须利用所有可用信息来确定灌注受损的新生儿。药物治疗应根据个体新生儿的特定生理紊乱进行调整。多巴胺是最常用的药物，可能是治疗舒张压降低的感染性休克的最合适药物。然而，对于其他低血压病因，应考虑替代疗法，包括用于新生儿持续性肺动脉高压的米力农和血管加压素，以及用于动脉导管未闭的多巴酚丁胺。需要进一步的研究来完善新生儿低血压的治疗方法，并记录接受治疗的新生儿的长期预后。
