Evaluation of Inotrope Use as a Risk Factor in Occurrence of Intraventricular Hemorrhage in Preterm Neonates | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 140, Volume 98, Issue 1, January 2025, Pages 977-984 PDF (574.11 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.415890 | ||
| Abstract | ||
| Background: The majority of intracranial hemorrhages, particularly in very premature infants, are intraventricular hemorrhages (IVH). Survivors of severe intracranial hemorrhage may experience post-hemolytic hydrocephalus, seizures, cerebral palsy, and cognitive delay as potential consequences. Objective: This work aimed to evaluate the occurrence of IVH in preterm infants with the use of inotropes. Patients and methods: This case control study was carried out on 50 preterm neonates with gestational age (GA) less than 34 weeks. Preterm neonates were divided into two equal groups: Group (A) received inotropic support within the 1st week of life and group (B) that did not need inotropic support. Cranial US was done at day one and day seven and after initiation of inotropes when indicated. Result: Development of IVH at day 7 was significantly higher in group A compared to group B (P<0.001). In group A, there was significant relation between use of inotropes and development of IVH at day 2, 3, 4, 5 and 6 (P<0.05). Calcium level showed significant decline in inotropic group compared to non-inotropic group (P=0.033). In univariate analysis: Using inotropes, lower GA, lower weight and low platelets levels were positively correlated with increased risk of IVH. In multivariate analysis, using model adjusted for previously mentioned parameters, it was found that using inotropes was the independent predictor for IVH. Conclusions: A standardized hemodynamic management approach aimed to minimize the need for inotropes, while preventing hypotension, which may reduce the incidence of IVH in preterm infants associated with inotropic use. | ||
| Keywords | ||
| Intraventricular hemorrhage; Inotrope; Transcranial Doppler ultrasound; Preterm | ||
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