4 *MYTHS* about Newborn Blood Pressure!! And why they're WRONG!!

Inotropes? Vasopressors? Why do we even CARE about BPs? What about Oxygenation status? What is a LOW blood pressure in a baby? Do we just care about the MEAN BP? Or systolic and diastolic BPs too? How should we treat hypotension? Should we always treat low BPs?

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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:

Mullaly R, El-Khuffash AF. Haemodynamic assessment and management of hypotension in the preterm. Arch Dis Child Fetal Neonatal Ed. 2024 Feb 19;109(2):120-127. doi: 10.1136/archdischild-2022-324935. PMID: 37173119.

St Peter D, Gandy C, Hoffman SB. Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions. Neonatology. 2017;111(3):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415.

Fanaroff JM, Wilson-Costello DE, Newman NS, Montpetite MM, Fanaroff AA. Treated hypotension is associated with neonatal morbidity and hearing loss in extremely low birth weight infants. Pediatrics. 2006 Apr;117(4):1131-5. doi: 10.1542/peds.2005-1230. PMID: 16585307

Dempsey EM, Barrington KJ, Marlow N, O'Donnell CPF, Miletin J, Naulaers G, Cheung PY, Corcoran JD, El-Khuffash AF, Boylan GB, Livingstone V, Pons G, Macko J, Van Laere D, Wiedermannova H, Straňák Z; HIP consortium. Hypotension in Preterm Infants (HIP) randomised trial. Arch Dis Child Fetal Neonatal Ed. 2021 Jul;106(4):398-403. doi: 10.1136/archdischild-2020-320241. Epub 2021 Feb 24. PMID: 33627329; PMCID: PMC8237176.

Faust K, Härtel C, Preuß M, Rabe H, Roll C, Emeis M, Wieg C, Szabo M, Herting E, Göpel W; Neocirculation project and the German Neonatal Network (GNN). Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life. Arch Dis Child Fetal Neonatal Ed. 2015 Sep;100(5):F388-92. doi: 10.1136/archdischild-2014-306483. Epub 2015 Jul 21. PMID: 26199082.

St Peter D, Gandy C, Hoffman SB. Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions. Neonatology. 2017;111(3):228-233. doi: 10.1159/000452616. Epub 2016 Nov 30. PMID: 27898415

Kluckow M, Evans N. Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F188-94. doi: 10.1136/fn.82.3.f188. PMID: 10794784; PMCID: PMC1721081.

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***TIMESTAMPS***
01:03 MYTH #1: 'Vasopressor' and 'Inotrope' mean same thing
05:23 Myth # 2: A blood pressure is a good indicator of a baby's Oxygenation status
11:04 Myth # 3: Mean BP is most important indicator of status
16:22 Myth # 4: Routinely treating hypotension in neonates improves outcomes
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

[ابراهيمهواري-سغ]

Another great video from Dr. Tala .. Thank U very much Dr. Tala .. I've learned a lot from that one.

[mahira]

Excellent revision....All examples quoted leave a permanent imprint. Easy for neurons to refire ...Thanks Dr Tala

[laraeb]

Another great video!!! Over the last 20 years, it has been great to see how much better hypotension is managed in neonates, we are getting better at not "over treating " hypotension. NIRS and more focused attention to perfusion markers has helped to decrease putting kids on meds based soley on numbers. Loved the breakdown of the myths that were considered law for so long. The HIP trial was a great try to find more answers. Getting IRB approval for that trial had to be "fun" 😂

[manuelapolderman]

Thanks for all your clear explanations in all your videos. Your YouTube channel is my favorite.

[bangaloresatish]

Excellent, excellent talk, especially, considering post on-call. Salute.

[lobzanglhadon]

Wonderful lectures.... thank you so much Doctor. Watching from India❤️

[nahedsamir]

Amazing presentation all the time
Great thanks from Egypt ❤

[naitramsingh]

amazing lectures as always, your videos always make learning fun, thanks to the entire team for all the amazing content and references 😊

[salemmelad]

Thank you Dr. Tala
That was really wonderful...
Watching you from Libya

[hayleymccrudden]

thanks Dr Tala! your videos have been a huge help on my studies as a neonatal ANP.

[andreadesormeaux]

Awesome video. I’m from Ottawa Canada. We use epi and norepi the most now it seems.

[ericamajernik]

Great video, I'm studying to take final exams and boards and this info is presented so easy to understand. When will the next videos in the series come out? I live in Ohio, we use Dopamine to start for low BP and then Epi.

[goelenys]

Thank you Dr. Tala! We use dopamine, dobutamine, (nor)adrenaline, milrinone. Greetings from Belgium

[felipeguinancio]

Very good vídeo Dr Tala! Thanks a lot. And have you ever made a video about NIRS monitorization? Do you have experience with this in your unit? Thanks a lot.

[mwewachansa]

neonatology made easy❤thank you Dr Tala.
watching you from zambia

[DRAmiraMohamed-owlk]

Thanks for your easy explanation, please could you explain apnea topic

[ahmedfaisal]

Maldives, norepinephrine for sepsis, dopamine used a lot, dobutamine for cardiogenic, for PPHN mostly end up using all 4 if bad as we have no NO

[santhisri]

Thank you so much mam.santhi from Tamilnadu.all videos super.

[anneshields]

Once again, you preformed well UNDER PRESSURE 😂

[docvaruna]

I am eagerly waiting for subsequent videos, which drug for which condition.