Adenosine infusion for the management of persistent pulmonary hypertension of the newborn*

Ng, Cho; Franklin, Orla; Vaidya, Mamta; Pierce, Christine; Petros, Andy

doi:10.1097/01.ccm.0000105309.27519.27

Cited by 43 publications

(21 citation statements)

References 7 publications

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“…However, the improvement in oxygenation was not sustained, and some infants had a decrease in oxygenation presumably related to worsening of VQ mismatch due to an increase in total pulmonary flow. Ng et al [106] reported that adenosine infusion (50 mg/kg/min) improved oxygenation and decreased pulmonary artery pressure in six of nine infants with PPHN already receiving INO therapy. ATPMgCl 2 infusion was shown to cause selective pulmonary vasodilation in children with post-operative pulmonary hypertension [107].…”

Section: Adenosine and Atpmentioning

confidence: 98%

New approaches for persistent pulmonary hypertension of newborn

Konduri

2004

Clinics in Perinatology

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Section: Adenosine and Atpmentioning

confidence: 98%

New approaches for persistent pulmonary hypertension of newborn

Konduri

2004

Clinics in Perinatology

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“…Posteriormente, Ng et al (29) demonstraram que a associação de dopamina, adenosina e óxido nítrico determina um aumento na oxigenação, com manutenção adequada de pressão arterial sistêmica.…”

Section: Discussionunclassified

Uso de milrinona no tratamento da hipertensão pulmonar persistente do recém-nascido

Eugénio

Georgetti

2007

Rev. paul. pediatr.

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RESUMOObjetivo: Descrever uma série de casos de recém-nascidos com hipertensão pulmonar persistente grave, que receberam milrinona para promover a vasodilatação pulmonar.Métodos: Análise retrospectiva de prontuários de 28 pacientes com diagnóstico de hipertensão pulmonar persistente do recém-nascido (HPPRN). Após o diagnóstico, todos os pacientes receberam uma dose de ataque de 50mcg/kg de milrinona, seguida por 0,75mcg/kg/min. O índice de oxigenação (IO) foi calculado no início da infusão e 72 horas após o início da medicação.Resultados: Todos os neonatos receberam milrinona e o sildenafi l foi associado em 54%. O uso de dopamina assegurou a manutenção da pressão arterial em nível adequado em todos os casos. Sedação contínua, alcalinização e surfactante foram medidas coadjuvantes no tratamento. Durante a internação, sete pacientes (25%) evoluíram a óbito e todos eles apresentaram aumento do IO, com elevação da média de 25 para 38 com a milrinona. Os sobreviventes, com exceção de um neonato, apresentaram redução do IO em uso de milrinona, com queda da média de 19 para 7.Conclusões: O uso da milrinona parece ser uma alternativa para o tratamento da HPPRN, na ausência do óxido nítrico. A redução do IO com a medicação foi fator determinante da boa evolução dos pacientes. O índice de falha no tratamento com a milrinona nesta casuística foi semelhante ao encontrado na literatura para o uso de óxido nítrico.Palavras-chave: síndrome da persistência do padrão de circulação fetal; inibidores de fosfodiesterase; milrinona. ABSTRACTObjective: To describe a series of neonates with severe persistent pulmonary hypertension, who received milrinone as the main treatment for pulmonary vasodilatation.Methods: Retrospective analysis by chart review of 28 neonates with persistent pulmonary hypertension. A dose of 0.75µg/kg/min of milrinone was given, after a loading dose of 50µg/kg. The oxygenation index (OI) was calculated before and 72 hours after the medication.Results: All infants received milrinone and sildenafi l was associated to milrinone in 54%. The use of dopamine assured normal blood pressure during milrinone treatment in all patients. Continuous sedation, alcalinization and surfactant were additional measures in the treatment. During the hospitalization period, seven (25%) patients died and all of them presented an OI increase after milrinone (the average OI rose from 25 to 38). All but one of the 21 surviving patients presented improvement of the OI with milrinone, with a reduction of the mean index from 19 to 7.Conclusions: Milrinone can be used to treat persistent pulmonary hypertension of the newborn, in the absence of nitric oxide. The reduction of the OI during treatment was associated with clinical improvement. The failure rate for milrinone treatment in this series of cases was similar to that found in the literature regarding nitric oxide.

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“…His weight being too low, the possibility of extracorporeal membrane oxygenation assistance was ruled out. We therefore started an infusion of adenosine at 50 g/kg/min as recommended by Konduri et al (1) and by Ng et al (2), once approval of our Institutional Review Board and the parents was obtained.…”

Section: Case Descriptionmentioning

confidence: 99%

Intravenous adenosine for refractory pulmonary hypertension in a low-weight premature newborn: A potential new drug for rescue therapy

Motti

Tissot

Rimensberger

et al. 2006

Pediatric Critical Care Medicine

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Adenosine infusion for the management of persistent pulmonary hypertension of the newborn*

Abstract: The use of adenosine infusion in combination with inhaled nitric oxide may be a potentially valuable therapeutic option for the treatment of pulmonary hypertension of the newborn. Neonates with irreversible lung pathology may not respond to adenosine infusion.

Cited by 43 publications

References 7 publications

New approaches for persistent pulmonary hypertension of newborn

New approaches for persistent pulmonary hypertension of newborn

Uso de milrinona no tratamento da hipertensão pulmonar persistente do recém-nascido

Intravenous adenosine for refractory pulmonary hypertension in a low-weight premature newborn: A potential new drug for rescue therapy

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