Vasopressin versus dopamine for treatment of hypotension in extremely low birth weight infants: a randomized, blinded pilot study

J Pediatr. 2015 Apr;166(4):850-5. doi: 10.1016/j.jpeds.2014.12.027. Epub 2015 Jan 29.


Objective: To evaluate vasopressin vs dopamine as initial therapy in extremely low birth weight (ELBW) infants with hypotension during the first 24 hours of life.

Study design: ELBW infants with hypertension ≤ 30 weeks' gestation and ≤ 24 hours old randomly received treatment with vasopressin or dopamine in a blinded fashion. Normotensive infants not receiving vasopressor support served as a comparison group.

Results: Twenty ELBW infants with hypertension received vasopressin (n = 10) or dopamine (n = 10), and 50 were enrolled for comparison. Mean gestational age was 25.6 ± 1.4 weeks and birth weight 705 ± 154 g. Response to vasopressin paralleled that of dopamine in time to adequate mean blood pressure (Kaplan-Meier curve, P = .986); 90% of infants in each treatment group responded with adequate blood pressure. The vasopressin group received fewer doses of surfactant (P < .05), had lower PaCO2 values (P < .05), and were not tachycardic (P < .001) during vasopressin administration, compared with the dopamine group.

Conclusions: Vasopressin in ELBW infants as the initial agent for early hypotension appeared safe. This pilot study supports a larger randomized controlled trial of vasopressin vs dopamine therapy in ELBW infants with hypotension.

Trial registration: NCT01318278.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure / drug effects*
  • Cardiotonic Agents
  • Dopamine / administration & dosage*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Hypotension / drug therapy*
  • Hypotension / physiopathology
  • Infant, Extremely Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / physiopathology
  • Infusions, Intravenous
  • Male
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage
  • Vasopressins / administration & dosage*


  • Cardiotonic Agents
  • Vasoconstrictor Agents
  • Vasopressins
  • Dopamine

Associated data