Early priorities in cardiovascular support in premature infants

Abstract 

Haemodynamic dysfunction in the first days of life is common in premature infants. They are prone to hypovolaemia and retain fetal circulatory connections hat potentially impair cardiac output and tissue perfusion. Immature organs are vulnerable to the effects of hypoperfusion with potentially debilitating or life-threatening consequences. Recognizing infants at risk, seeking to maintain an adequate circulating volume and providing them with appropriate inotropic support are crucial to optimizing their care. There is evidence that early treatment to close the ductus arteriosus mitigates some of the malignant effects of ductal shunting. Clinical assessment of cardiovascular function is not always straightforward. The increasing use of echocardiography by neonatologists means that more informed decisions about cardiovascular management can be made.

Keywords: prematurity, blood pressure, patent ductus arteriosus, inotropes

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• f1 Correspondence to: MS. E-mail: mark.sellwood@uclh.org