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Related Experiment Video

Updated: Nov 16, 2025

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

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Published on: April 18, 2025

Hypotension in Preterm Infants (HIP) randomised trial.

Eugene M Dempsey¹, Keith J Barrington², Neil Marlow³

¹Department of Paediatric and Child Health and INFANT Research Centre, University College Cork, Cork, Ireland g.dempsey@ucc.ie.

Archives of Disease in Childhood. Fetal and Neonatal Edition

|February 25, 2021

Summary

Restricting inotrope use in premature infants with low blood pressure (BP) did not significantly affect survival without brain injury. This study suggests similar outcomes between standard and restrictive BP management strategies in neonates.

Keywords:

cardiology neonatology pharmacology

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Area of Science:

Neonatalogy
Pediatric Cardiology
Clinical Trials

Background:

Low blood pressure (BP) is common in preterm infants.
Inotropes are frequently used to manage hypotension in neonates.
Evidence is limited on optimal BP management strategies.

Purpose of the Study:

To investigate if restricting inotrope use impacts survival without significant brain injury in preterm infants.
To compare standard versus restrictive management of low BP in infants born before 28 weeks of gestation.

Main Methods:

A double-blind, placebo-controlled randomized trial was conducted across 10 European and Canadian sites.
Infants born before 28 weeks of gestation with persistent low BP and no severe intraventricular hemorrhage were enrolled.
Participants received either standard dopamine infusion or a restrictive placebo (5% dextrose) infusion for low BP management.

Main Results:

The trial was terminated early due to low recruitment.
No significant difference in survival without severe brain injury was observed between the standard (62%) and restrictive (69%) groups (p=0.58).
The standard group required fewer additional treatments for low BP (38% vs 66%, p=0.038).

Conclusions:

Despite limitations in statistical power, no major differences in clinical outcomes were found between standard and restrictive BP management.
The findings provide preliminary data to inform future research on managing hypotension in extremely preterm infants.
Further powered studies are needed to definitively assess the impact of different BP management strategies.