When hypotension should be treated and with what are important and difficult questions in the care of the very preterm infant. The international HIP collaboration (see the link in the side bar) has been funded to try and find some answers. One thing we wanted to do at the outset was to see if things had changed much recently, which has led to our first publication (Stranak Z, Semberova J, Barrington K, O’Donnell C, Marlow N, Naulaers G, Dempsey E, On behalf of the HIP consortium: International survey on diagnosis and management of hypotension in extremely preterm babies. Eur J Pediatr 2014:1-6) 73% of the respondents defined hypotension as a mean blood pressure less than the GA in weeks. When hypotension is diagnosed then the therapeutic approaches are very variable, and seem to differ by region, southern European babies are less likely to be hypovolemic it seems.

There is as much variability as in the past, but more units are using functional echocardiography to analyze the hemodynamic situation, about 3/4 of our respondents).