Department of Pediatrics, CHU Ste-Justine, University of Montreal, Montreal, QC, Canada.
Acta Paediatr. 2018 Mar;107(3):408-413. doi: 10.1111/apa.14112. Epub 2017 Oct 26.
This study evaluated the clinical and haemodynamic effects of norepinephrine infusion in preterm infants.
The effects of norepinephrine therapy for refractory hypotension were evaluated in preterm infants between April 2009 and April 2011 at the neonatal intensive care unit of Sainte-Justine Hospital, Montreal, Quebec. Changes in haemodynamics and clinical parameters were analysed eight hours before and eight hours after the start of norepinephrine infusion, and eight hours after its cessation.
During the study, 30 preterm infants at a mean gestational age of 26.5 ± 2.6 weeks (median: 25.7, 23.4-34) and birthweight of 903 ± 437 g (median 827, 450-2550) received norepinephrine infusion for neonatal septic shock. After eight hours of treatment, mean blood pressure, urine output and FiO significantly improved. Eight hours after cessation of norepinephrine infusion, the number of patients treated with other inotropes decreased significantly, 24 patients (80%) had normal mean blood pressure and 27 patients (90%) had normal urine output.
Norepinephrine therapy could be considered to improve blood pressure and urine output during neonatal septic shock in preterm infants. Further studies are needed to prove the efficacy and safety of norepinephrine infusion in neonates.
本研究评估了去甲肾上腺素输注对早产儿的临床和血液动力学影响。
2009 年 4 月至 2011 年 4 月，在魁北克省蒙特利尔 Sainte-Justine 医院的新生儿重症监护病房，评估了去甲肾上腺素治疗早产儿难治性低血压的效果。在开始去甲肾上腺素输注前 8 小时、输注后 8 小时和停止输注后 8 小时，分析血液动力学和临床参数的变化。
在研究期间，30 名早产儿的平均胎龄为 26.5±2.6 周（中位数：25.7，23.4-34），出生体重为 903±437g（中位数 827，450-2550），因新生儿败血症休克接受去甲肾上腺素输注。治疗 8 小时后，平均血压、尿量和 FiO2 显著改善。去甲肾上腺素输注停止 8 小时后，需要其他正性肌力药物治疗的患者数量显著减少，24 名患者（80%）的平均血压正常，27 名患者（90%）的尿量正常。
去甲肾上腺素治疗可考虑用于改善早产儿新生儿败血症休克时的血压和尿量。需要进一步研究证明去甲肾上腺素输注在新生儿中的疗效和安全性。
