Vasopressin and its analogues for the treatment of refractory hypotension in neonates

Shivanna, Binoy; Rios, Danielle R.; Rossano, Joseph W.; Fernandes, Caraciolo J; Pammi, Mohan

doi:10.1002/14651858.cd009171

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…In case series both medications were reported to be effective in increasing blood pressure, urine output and decreasing inotrope requirements [88].…”

Section: Evidence and Pd Effectsmentioning

confidence: 99%

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Ergenekon

Rojas-Anaya

Bravo

et al. 2018

CPD

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Background: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. Methods: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000.Results: Out of 101 identified eligible studies only 22 studies met the criteria for evidence based practice guidelines level I to IV. The most prevalent pharmacodynamic effects were increase in blood pressure and/or heart rate, which were also the most frequently studied circulatory parameters. Conclusion: This review demonstrates the need for further systematic studies on all reviewed drugs with incorporation of novel noninvasive biomarkers in this vulnerable patient group, for more timely and appropriate treatment for clinical efficacy.

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“…In case series both medications were reported to be effective in increasing blood pressure, urine output and decreasing inotrope requirements [88].…”

Section: Evidence and Pd Effectsmentioning

confidence: 99%

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Ergenekon

Rojas-Anaya

Bravo

et al. 2018

CPD

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“…21 22 Despite the promising outlook, the evidence on the efficacy and safety of AVP and its analogues remains controversial, particularly regarding the short-term and long-term adverse effects in preterm neonates. [23][24][25][26] Reports of serious adverse events such as decreased cardiac index, peripheral cyanosis and digital ischaemia are among complications that require further investigation. 26 A recent systematic review and meta-analysis that examined the role of vasopressin and terlipressin in refractory shock in paediatric patients, reported improvements in haemodynamic indices but lack of benefit on mortality or length of hospital stay with a trend towards a higher risk for tissue ischaemia.…”

Section: What This Study Hopes To Add?mentioning

confidence: 99%

Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review

Al-Saadi

Sushko

Bui

et al. 2021

bmjpo

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BackgroundThe use of vasoactive agents like arginine vasopressin (AVP) and terlipressin to treat hypotension or persistent pulmonary hypertension in critically ill preterm neonates is increasing. Therefore, a systematic review of the available data on dosing, efficacy and safety of AVP and terlipressin in this patient population appears beneficial.MethodsWe will conduct a systematic review of the available evidence on the use of AVP and terlipressin for the treatment of hypotension or persistent pulmonary hypertension in preterm neonates. We will search Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar from inception to March 2021. Two reviewers will independently screen titles and abstracts, review the full text of eligible studies, extract data, assess the risk of bias and judge the certainty of the evidence. Our primary outcome will be an (1) improvement of end-organ perfusion after initiation of AVP or terlipressin and (2) mortality prior to discharge. Our secondary outcomes will include (1) major neurosensory abnormality and (2) the occurrence of adverse events.DiscussionThe currently available evidence on the efficacy and safety of AVP and terlipressin in preterm neonates is limited. Yet, evidence on the pharmacology of these drugs and the pathophysiology of vasoplegic shock support the biological plausibility for their clinical effectiveness in this population. Therefore, we aim to address this gap concerning the use of vasopressin and terlipressin among critically ill preterm neonates.Trial registrationThis protocol has been submitted for registration to the international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).

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“…In addition, it has a vasodilatory effect on cerebral and renal arterioles by stimulation of vasopressin V2 receptors. Overall data on the use in preterm and term neonates is limited and mostly reported as case series [73][74][75][76][77][78] . Dosing is by continuous infusion of 0.00001-0.003 unit/kg/min.…”

Section: Vasopressinmentioning

confidence: 99%