 Since most extremely preterm infants are critically ill in the immediate postnatal period, establishing normal blood pressure BP values is difficult. This lack of data makes deciding when to institute therapy for hypotension low BP challenging, leading to considerable variability in BP management in neonatal intensive care units NICUs. Despite a lack of data on safety or efficacy, as many as 64 of extremely preterm infants receive inotropes e.g., dopamine, and up to 12.4 of very low birthweight infants receive hydrocortisone for perceived hypotension. Since both untreated low BP and therapy provided for low BP may be harmful, the decision of whether to treat is an important issue. To date, no prospective randomized, controlled trial of BP management in this population has been performed. 