WP03 - Survey - Use of inotropes in hypotension

 

Workpackage lead and partners:

WP leader:
Dr. Zbynek Stranak, CUNI

WP partners:
UCC

Workpackage objectives: 

  • To increase knowledge about current strategies for diagnosing neonatal hypotension in the first 72 hours in European neonatal intensive care units (NICUs) in extremely low birth weight infants.
  • To increase knowledge about neonatal hypotension treatment practices in Europe by performing a survey on current strategies for management of hypotension.

 

Workpackage description:

A web-based survey will be created and distributed to neonatologists throughout Europe, in order to reflect differences in diagnosis and treatment of hypotension in the extreme preterm infant in the first 72 hours of life, within the European Union and other European countries. The survey will include questions about current strategies for diagnosis, and indication for treatment. A similar study performed in Canada, from partners in the present proposal, has demonstrated that clinical diagnosis of suspected neonatal hypotension is very variable, and is associated with varying treatment strategies. The survey will also contain questions about the use of echo, NIRS and continuous EEG- and aEEG-monitoring in neonatal intensive care units. The clinicians' preferences for various inotropes will be investigated. The clinicians will be asked whether their units have written guidelines for treatment of hypotension, and about their preferred first, second and third line medications for the treatment of hypotension.

Task 1 Protocol for survey:

During the first 3 months, a protocol will be created and contacts will be taken through Europe for optimal distribution of the survey, mainly to university hospitals. The partners involved in this proposal have large formal and informal networks within neonatology.

Task 2 Survey:

During the second 3 month period, the survey will be sent out (to non-responders twice). Since the survey is web-based, it will be possible to build in direct feed-back when a clinician has responded to the survey (e.g. how did other clinicians reply to a certain question), which is both didactic and is expected to raise the number of responders.

Task 3 Analysis:

Data collection and analysis will be performed during the following 4 months.

Task 4 Report:

Two months will be needed for writing the report. The survey in itself, and the information from the survey on how hypotension is diagnosed will raise the overall awareness about the specific difficulties in diagnosing hypotension. This survey, and new research, can form a basis for practical guidelines on how to optimise diagnosis of hypotension in neonatal intensive care units through Europe, and on the use of other monitoring may prove valuable. Such guidelines will also make the overall diagnosis of neonatal hypotension more precise with less administration of unnecessary and potentially toxic medications.

Collaboration within the consortium:

This WP is closely associated with WP 02 (Education and training) and WPs 05, 06, 07 because the results will have implications for the training tools that will be developed in WP 02 (Objective: To develop a web-based educational tool for clinicians on diagnosis and management of hypotension) and in WP 06 we will further investigate how to optimise the diagnosis of hypotension.