Hypotension in the Neonate: They're NOT Just Little Adults

What is hypotension in a neonate and how do you treat it appropriately? Is this based purely on the mean blood pressure, or are there other factors to consider? When a baby is born and the cord is cut, many things change. As the cardiovascular system of a preterm neonate matures over time, the actual composition of a baby's cardiac structure changes, which impacts how babies respond to different pressors. We will review the physiological development of the preterm and term newborn's cardiovascular system, and attempt to define hypotension in the newborn. Then we will explore various treatment options, including volume expanders and different pressors. Once you understand the physiology, the treatment options and how they work in both preterm and term neonates, you can make a more informed decision when choosing the best pressor for your patient, no matter their gestational age. You will become confident in managing hypotension in neonates, even if your treatment choices are limited while transporting our tiniest patients.