초극소 저출생 체중아에서 저혈압의 빈도 및 원인 분석
Frequency and Etiologies of Hypotension in Extremely Low Birth Weight Infants
김은선, 김재리, 임인숙, 최창원, 김병일, 김상덕, 김이경, 최중환, 김도현, 김한석, 신승한, 정경은,
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김은선 ( Kim Eun-Sun )
서울대학교 의과대학 소아과학교실
김재리 ( Kim Jae-Lee )
서울대학교 의과대학 소아과학교실
임인숙 ( Im In-Suk )
서울대학교 의과대학 소아과학교실
최창원 ( Chol Chang-Won )
서울대학교 의과대학 소아과학교실
김병일 ( Kim Beyong-Il )
서울대학교 의과대학 소아과학교실
김상덕 ( Kim Sang-Duk )
서울대학교 의과대학 소아과학교실
김이경 ( Kim Ee-Kyung )
서울대학교 의과대학 소아과학교실
최중환 ( Choi Jung-Hwan )
서울대학교 의과대학 소아과학교실
김도현 ( Kim Do-Hyun )
서울대학교 의과대학 소아과학교실
김한석 ( Kim Han-Suk )
서울대학교 의과대학 소아과학교실
신승한 ( Shin Seung-Han )
서울대학교 의과대학 소아과학교실
정경은 ( Joung Kyoung-Eun )
서울대학교 의과대학 소아과학교실
KMID : 0438520060130020216
Abstract
Purpose: Hypotension is common in extremely low birth weight infants (ELBWI) and the treatment becomes important as the survival rate of ELBWI is increasing. This study is to investigate frequency and etiologies of hypotension in ELBWI.
Methods: 40 patients admitted to the NICU of Seoul National University Children’s Hospital from September 2004 to June 2006 were included retrospectively. Definition of hypotension was 1) mean arterial blood pressure below 30 mmHg or below the gestational age, 2) decreased urine output or metabolic acidosis, and 3) use of inotropics. Hydrocortisone was used for inotrope-resistant hypotension. Clinical characteristics of patients with hypotension were compared with those of others without hypotension.
Results: Mean gestational age and mean birth weight of 40 patients was 26(+6)+/-2(+1) weeks and 787+/-149 g. 20 patients had hypotension. 17 events were within 1 week of postnatal age, 5 from 1 to 2 weeks, and 9 after 2 weeks. The etiologies of hypotension within 1 week were PDA in 12 cases, and bleeding in 4 cases. PDA, post-operative condition, adrenocortical insufficiency, and sepsis were the probable etiologies of hypotension after 2 weeks. Among 12 patients recieved hydrocortisone, 9 responded to hydrocortisone. Patients with hypotension were significantly low in gestational age and birth weight. Incidence of IVH and ROP were significantly high in patients with hypotension.
Conclusion: Hypotension was frequent in ELBWI and the etiologies of hypotension were various according to postnatal ages. Significant proportion of hypotension was inotrope-resistant in ELBWI. Further studies about etiologies are in need with reference of this study.
키워드
Extremely low birth weight infants;Hypotension;Hydrocortisone
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