February 2018 | Volume 6 | Article 15 1 CLINICAL TRIAL published: 01 February 2018 doi: 10.3389/fped.2018.00015 Frontiers in Pediatrics | www.frontiersin.org Edited by: Eugene Dempsey, University College Cork, Ireland Reviewed by: Kai König, Mercy Hospital for Women, Australia *Correspondence: Gerhard Pichler gerhard.pichler@medunigraz.at Specialty section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics Received: 22 October 2017 Accepted: 16 January 2018 Published: 01 February 2018 Citation: Pichler G, Höller N, Baik-Schneditz N, Schwaberger B, Mileder L, Stadler J, Avian A, Pansy J and Urlesberger B (2018) Avoiding Arterial Hypotension in Preterm Neonates (AHIP)— A Single Center Randomised Controlled Study Investigating Simultaneous Near Infrared Spectroscopy Measurements of Cerebral and Peripheral Regional Tissue Oxygenation and Dedicated Interventions. Front. Pediatr. 6:15. doi: 10.3389/fped.2018.00015 Avoiding Arterial Hypotension in Preterm Neonates (AHIP)— A Single Center Randomised Controlled Study Investigating Simultaneous Near Infrared Spectroscopy Measurements of Cerebral and Peripheral Regional Tissue Oxygenation and Dedicated Interventions Gerhard Pichler 1,2 *, Nina Höller 1,2 , Nariae Baik-Schneditz 1,2 , Bernhard Schwaberger 1,2 , Lukas Mileder 1,2 , Jasmin Stadler 1,2 , Alexander Avian 3 , Jasmin Pansy 1,2 and Berndt Urlesberger 1,2 1 Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria, 2 Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria, 3 Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simul- taneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catechol- amine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study. Blood pressure was measured non-invasively or invasively. In the NIRS group, simultaneous cTOI and pTOI monitoring was used start- ing within 6 h after birth for 24 h to calculate changes in cTOI/pTOI ratio over time. Depending on these changes, interventions including echocardiography, administration of volume or patent ductus arteriosus treatment were performed. In the control group, only routine monitoring and treatment were performed and NIRS signals were not visible. The primary outcome was burden of hypotension within 48 h after initiation of NIRS monitoring. Results: 49 preterm neonates were included in each group: NIRS group 33.1 (32.0– 34.0) (median: 25–75 centile) weeks of gestation and control group 33.4 (32.3–34.3) weeks of gestation. In the NIRS group, echocardiography was performed in 17 preterm neonates due to NIRS measurements, whereby six neonates received further treatment.