Central-peripheral temperature difference, blood pressure, and arginine vasopressin in preterm neonates undergoing volume expansion

Aim-To examine the effect of intravascular volume expansion for the treatment of hypovolaemia in sick preterm neonates. Methods-An intravenous infusion of 20 ml per kg of 4.5 % albumin was given to 14 preterm neonates. The effects on systolic blood pressure, central peripheral temperature difference (c-pT), and plasma arginine vasopressin concentration (pAVP) were measured. Results-Thirteen babies showed a rise in systolic blood pressure. The six babies with the highest initial values of pAVP and c-pT showed a fall in both of these after infusion. The babies with lower initial pAVP (below 4 pmol/l) showed either a rise (two) or no change (six) after albumin infusion. There was a significant correlation between c-pT and log pAVP before (r(2)=0.61; p<0.05) and after infusion (r(2)=0.45; p<0.05). Conclusions-Plasma AVP concentration is related to c-pT in unwell preterm newborns. This study suggests that clinical assessment of hypovolaemia in preterm newborns is poor and could be improved by using c-pT.