{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:12:59Z","timestamp":1771459979680,"version":"3.50.1"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate the effect of a standardized blood pressure (BP) chart and neonatal hypotension management guidelines on inotrope use and clinical outcomes in preterm infants.<\/jats:p>\n                  <jats:p>Retrospective cohort study of preterm infants (&lt;32 weeks gestational age (GA)) at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. We compared data before (EPOCH1) and after (EPOCH2) implementing the BP chart and hypotension guidelines. Extracted variables included maternal\/neonatal characteristics, inotrope use, morbidity, and mortality. Statistical significance was set at p\u2009&lt;\u20090.05.<\/jats:p>\n                  <jats:p>Among 384 infants (192 per epoch), overall inotrope use declined significantly in EPOCH2 (33.9 vs. 17.7%, p\u2009&lt;\u20090.001). In the hypotension subgroup, EPOCH1 infants had higher GA, birth weight, and 5- and 10-minute APGAR scores. After implementation, dopamine (58.5 vs. 14.7%, p\u2009&lt;\u20090.001) and fluid bolus (80 vs. 41.2%, p\u2009&lt;\u20090.001) use decreased, whereas norepinephrine (26.2 vs. 70.6%, p\u2009&lt;\u20090.001) and hydrocortisone (46.2 vs. 82.4%, p\u2009&lt;\u20090.001) increased. Inotrope therapy was triggered at lower mean arterial pressure and systolic\/diastolic thresholds; duration of inotrope use also dropped (4.2 vs. 2.6 days, p\u2009&lt;\u20090.034). Periventricular leukomalacia rates fell (15.1 vs. 6.5%, p\u2009&lt;\u20090.007), with no significant differences in overall mortality, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity, or necrotizing enterocolitis. However, early mortality (&lt;72\u2009hours) in hypotensive infants was reduced (64.3 vs. 26.7%, p\u2009&lt;\u20090.042).<\/jats:p>\n                  <jats:p>The implementation of BP charts and hypotension management guidelines was associated with a significant reduction in the use of inotropes and fluid boluses, indicating a more standardized and objective approach to BP management in preterm infants. These changes reflect improved clinical decision-making based on defined BP thresholds, resulting in greater consistency in the timing and selection of interventions while potentially minimizing the risks linked to unnecessary cardiovascular support.<\/jats:p>","DOI":"10.1055\/a-2649-1383","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T22:53:20Z","timestamp":1753397600000},"page":"498-507","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Implementing a Standardized Neonatal Blood Pressure Chart and Neonatal Hypotension Management Guidelines in the Neonatal Intensive Care Unit: A Retrospective Cohort Study"],"prefix":"10.1055","volume":"43","author":[{"given":"Hanof","family":"Bakri","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohanned","family":"Alrahili","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Alkaabi","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Almahdi","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman","family":"Bazbouz","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Almuqati","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manayf","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwag","family":"Alsubaie","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seham","family":"Alrsheedi","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amenah A.","family":"Essa","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musab","family":"Alshareef","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal","family":"Alsehli","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"},{"name":"Department of Neonatal Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saif","family":"Alsaif","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"},{"name":"Department of Neonatal Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"},{"name":"Department of Neonatal Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz","family":"Homedi","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia"},{"name":"Department of Neonatal Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"issue":"06","key":"ref1","first-page":"470","article-title":"Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study","volume":"15","author":"A B Zubrow","year":"1995","journal-title":"J 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