The paper by Thewissen et al. in this issue of Pediatric Research reports a result of a major effort of testing the value of dopamine for the purpose of safeguarding the brain of extremely preterm infants.1 Dopamine has a long track record, but—shame on us—still lacks proof of value, in terms of improving clinical outcomes.

The circumstances of this paper are interesting in themselves. It is a report of a prospective cohort study of blinded monitoring of cerebral oxygenation (brain tissue oxygenation—StO2—by near-infrared spectroscopy) within a randomized placebo-controlled trial. The target of the HIP (hypotension in preterm infants) trial was to randomize 340 infants, but the trial was stopped after 30 months when 58 infants had been enrolled at ten sites,2 thus confirming the conclusions of a previous ambitious effort of addressing the clinical value of treating arterial hypotension in preterm infants.3 The trial director recently reviewed the history of the odyssey of trialists to test the value of “haemodynamic support” in order to point out lessons learnt and the remaining obstacles.4

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