Vliv časné aplikace hydrokortizonu na krevní tlak u novorozencůextrémně nízké porodní hmotnosti

The Effect of the Early Hydrocortisone Administration on the Blood Pressure in ExtremelyLow BirthWeight Infants

Objectives:
In the submitted study the author evaluates the effect of the early hydrocortisone applicationimmediately after birth on the blood pressure in the premature infants of the birth weight under 1000 g. At thesame time an impact of the early hydrocortisone application on the dose of dopamine given to the newborns afterbirth is questioned. The study also investigates earlymorbidity andmortality (periventricular leucomalatia, exitus,intraventricular haemorrhage).Design of study: Retrospective analysis.Subject: 64 premature infants ELBW of birth weight under 1000 g, born from 1998 to 2000.Results: During the first 48 hours of life, the premature newborns exposed to hydrocortisone had higher meanblood pressure in 21 time episodes from 24 than newborns in the control group (P < 0.01). A significant differencein the minimal level of mean blood pressure during the first 24 hours was found, the treated group having highervalues (P = 0.033). In these both groups approximately the same dose of dopamine was given. The frequency of theintraventricular haemorrhages was 2/34 (5.9%) in treated group and 6/30 (20.0%) in non-treated group, notreaching statistical significance (P > 0.05). Mortality was significantly lower in the exposed group 6/34 (17.6%),compared with 13/30 (43.3%) (P = 0.049). The periventricular leucomalatia incidence was 1/34 (2.9%) in the groupof treated infants and 1/30 (3.3%) in the group of non-treated (P > 0.05).Conclusion: A significant hydrocortisone effect on the absolute blood pressure values was found. No differencewas observed in the dopamine dose in both groups of infants. The infants in the hydrocortisone group presenteda significantly lower mortality than infants in the non-hydrocortisone group.Abbreviations: ELBW, extremely low birth weight infants.

Key words:
hydrocortisone, dopamine, blood pressure, extremely low birth weight infants