• Margrete Larsen Burns, Hans Jørgen Stensvold, Kari Risnes, Hans Jørgen Guthe, Henriette Astrup, S Marianne Nordhov, Terje Reidar Selberg, Arild Rønnestad, Astri Maria Lang, and Norwegian Neonatal Network.
• 1Department of Pharmacology, Oslo University Hospital Ulleval, Oslo, Norway.2Department of Neonatology, Oslo University Hospital Rikshospitalet, Oslo, Norway.3Department of Pediatrics, St Olav University Hospital, Trondheim, Norway.4Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.5Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.6Department of Pediatrics, Hospital of Southern Norway, Kristiansand, Norway.7Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway.8Department of Pediatrics, Ostfold Hospital Trust, Kalnes, Norway.9Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
• Pediatr Crit Care Me. 2016 Oct 1; 17 (10): 948-956.

ObjectiveTo describe the use of inotropic drugs and the characteristics of neonates receiving such treatment in a national cohort of patients admitted to neonatal ICUs in Norway.DesignA national registry study of patients included in the Norwegian Neonatal Network database 2009-2014. Demographic and treatment data, including the use of inotropic drugs (dopamine, dobutamine, epinephrine, norepinephrine, milrinone, and levosimendan) and outcomes, were retrieved and analyzed.SettingNeonatal ICUs in Norway.PatientsAll patients admitted to Norwegian neonatal ICUs 2009-2014 with a postmenstrual age of less than 310 days at admission, corresponding to a postnatal age of less than 28 days for a child born at term (n = 36 397).InterventionsNone.Measurements And Main ResultsInotropic drugs were administered to 974 of 361,803 live born infants (0.27%) in the study period, representing 2.7% of the neonatal ICU patient population. The relative proportion of neonatal ICU patients receiving inotropes decreased with increasing gestational age, yet 41% of the patients receiving inotropes were born at term. Of note, 89.8% of treated patients received dopamine. Use of inotropes was particularly prevalent in patients with necrotizing enterocolitis (72.4%) and pulmonary hypertension (42.1%) and in patients with gestational age less than 28 weeks (28.2%). Inotropic treatment initiated in the first week of life (84.2%) was associated with birth asphyxia and pulmonary hypertension, whereas treatment initiated after the first week of life was associated with extremely preterm birth, neonatal surgery, neonatal sepsis, cardiac disease, and necrotizing enterocolitis.ConclusionsThis comprehensive epidemiologic study indicates that less than 0.3% of newborns receive inotropic support in the neonatal period. Dopamine was the most commonly used drug. Relating inotrope use to clinical condition, gestational age, and postnatal age may be useful for clinicians and helpful in delineating relevant patient populations for future clinical trials.

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