Blood pressure is only one component of neonatal hemodynamic assessment and should not be used in isolation to direct management. A “normal” blood pressure does not exclude clinically significant hypoperfusion when accompanied by oliguria, rising creatinine, elevated lactate, down-trending regional oxygen saturation (NIRS), weak pulses, or prolonged capillary refill.
Hemodynamic drug effects are simplified qualitative estimates based on typical neonatal use and may vary by dose and clinical context. Arrow magnitude is intended to reflect general tendencies within each domain; they are not quantitative comparisons between drugs or across domains.
Blood Pressure by Age
| 5th Percentile | 50th Percentile | 95th Percentile |
|---|---|---|
| —/— (—) | —/— (—) | —/— (—) |
| ⓘ Reference notes | ||
| Drug | Dose | Tropies | Afterload | |||||
|---|---|---|---|---|---|---|---|---|
| Name | Start | Max | Ino | Chrono | Lusi | SVR | PVR | |
| Dopamine µg/kg/min |
2 | 10 | ↑ | ↑↑ | =/↑ | =/↑ | ↑↑ | |
| 10 | 20 | ↑ | ↑↑↑ | ↓ | ↑↑ | ↑↑↑ | ||
| Dobutamine µg/kg/min |
5 | 15 | ↑↑↑ | ↑↑ | ↑↑ | =/↓ | =/↓ | |
| Epinephrine µg/kg/min |
0.02 | 0.1 | ↑↑ | ↑↑ | =/↑ | ↑ | =/↓ | |
| 0.1 | 0.5 | ↑↑ | ↑↑↑ | ↓ | ↑↑↑ | ↑↑ | ||
| Milrinone µg/kg/min |
0.2 | 0.75 | ↑↑ | ↑ | ↑ | ↓↓↓ | ↓↓ | |
| Norepinephrine µg/kg/min |
0.05 | 0.5 | ↑↑ | ↑ | =/↑ | ↑↑↑ | ↑↑ | |
| Vasopressina mU/kg/min |
0.1 | 1 | = | =/↓ | = | ↑↑↑ | =/↓ | |
| Hydrocortisoneb mg/kg/day |
2 | 4 | = | = | = | ↑↑ | = | |
|
aAntidiuretic that may cause water retention. Caution in oliguria or anuria. Consider serial sodium levels at least q6 hours.
bHydrocortisone dosing frequency divided q6-12 hr. Higher doses not shown to be superior in extremely preterm infants. |
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