How does HiP work?
The primary objective of HiPis to determine whether an observational approach rather than a standard dopamine approach to the management of hypotension in these infants within the first 72 hrs of life improves:
- Survival free from neurodevelopmental disability at 2 years corrected GA.
- Survival without significant brain injury at 36 weeks corrected GA.
To this end, each infant involved in the trial will receive a structured neurological assessment, a developmental assessment using the BayleyScales of Infant Development (BSID-III), functional measures of motor (GMFCS), sensory and communication impairments, and a standardised parent-report evaluation of social and adaptive functions. These tests will give an overview of the infant’s cognitive ability, motor status and behaviour.
Extremely preterm infants are frequently diagnosed with hypotension and treated with inotropic and pressor drugs in the immediate postnatal period. Dopamine is the most commonly used first-line drug. Babies who are treated for hypotension more frequently sustain brain injury, have longterm disability or die compared to those who are not. Despite the widespread use of drugs to treat hypotension in such infants, evidence for efficacy is lacking, and the effect of these agents on long-term outcomes is unknown.
"Extremely Pre-Term" is a baby born before 28 weeks' gestation.