ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Clinical and echocardiographic response to volume expansion in hypotensive preterm infants: a pilot observational study
Provisionally accepted
- Centre Hospitalier Universitaire de Nancy, Nancy, France
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Objective To describe the short-term clinical and echocardiographic effects of a first volume expansion in hypotensive preterm infants during the first 24 hours of life. Study design Single-center retrospective observational pilot study including preterm infants ≤31 + 6 weeks of gestation, intubated and mechanically ventilated, presenting arterial hypotension within 24 hours of life. All infants received a first volume expansion with modified fluid gelatin (20 ml/kg). Clinical and echocardiographic parameters were compared immediately before and after volume expansion. Results Thirty-one infants were included. Volume expansion was associated with a significant increase in systolic, diastolic and mean arterial pressure (median MAP increase: +4 mmHg; +17%), and a significant decrease in heart rate and capillary refill time. Echocardiographic assessment showed a significant increase in left ventricular end-diastolic diameter and superior vena cava flow (median increase: +19%), suggesting improved preload and systemic blood flow. No immediate clinically apparent adverse events were recorded during the observation period. Conclusion In this exploratory pilot study, a first volume expansion was associated with short-term improvements in clinical and echocardiographic hemodynamic parameters in hypotensive preterm infants. These findings are hypothesis-generating and cannot be generalized to current filling strategies or repeated fluid boluses.
Keywords: Hemodynamic impairment, neonate, preterm, ultrasound, Volume expansion
Received: 19 Nov 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 LALIN, Jellimann and HASCOET. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Océane LALIN
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