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Treatment of neonatal hemodynamic compromise


Authors: J. Širc;  Z. Straňák
Authors‘ workplace: 3. lékařská fakulta Univerzity Karlovy, Praha ;  Ústav pro péči o matku a dítě, Praha
Published in: Čes-slov Neonat 2022; 28 (1): 28-34.
Category: Reviews

Overview

Acute circulatory failure (ACF) is a serious and life-threatening complication in a newborn. ACF can occur throughout the whole neonatal life. Diagnosis of ACF is complicated by the size of patients, limited invasive methods and presence of intra and extracardiac shunts. The spectrum of drugs affecting the circulatory system is relatively broad. However, explored effects are often based on experimental studies or studies in adults. Thus, it is difficult to extrapolate these conclusions to neonates. Moreover, each drug affects the circulation at a different level and in a different way. The optimal therapy must therefore be tailored and the effect on hemodynamics must be monitored accordingly. Recently published data revealed that we can sufficiently influence some parameters of the circulatory system in circulatory compromised newborns, but without a positive effect on long-term neurological outcome.

Keywords:

corticosteroids – Catecholamines – Hypotension – Vasopressin – Norepinephrine – epinephrine – haemodynamic support – dopamin – dobutamin – milrinone – sildenafil – levosimendan


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