Vasopressin as a Rescue Therapy for Refractory Pulmonary Hypertension in Neonates

Mohamed, Adel; Nasef, Nehad; Shah, Vibhuti Kumar; McNamara, Patrick J.

doi:10.1097/pcc.0b013e31829f5fce

Cited by 74 publications

(40 citation statements)

References 41 publications

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“…Experience with AVP/TP in neonates has been more focused on term newborns with congenital heart disease who develop hypotension after surgery, newborns with PPHN or with septic shock all reporting increased blood pressure, most reporting increased urine output and some reporting decreased lactate levels coming from retrospective studies or case series [85,[90][91][92][93][94][95].…”

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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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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“…Since iNO inhibits PDE3 activity both in vitro and in vivo, milrinone may also be particularly effective as adjunctive therapy for iNO [36,37]. Arginine vasopressin was recently reported to improve both oxygenation and systemic hypotension in infants with PPHN and congenital heart disease [38]; more studies are needed to determine its mechanism of action and safety.…”

Section: Cardiac Supportmentioning

confidence: 99%

Advances in Neonatal Pulmonary Hypertension

Steinhorn¹

2016

Neonatology

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Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay. Milrinone may have specific benefits as an ‘inodilator', as prolonged exposure to iNO plus oxygen may activate phosphodiesterase (PDE) 3A. Additionally, sildenafil and hydrocortisone may benefit infants exposed to hyperoxia and oxidative stress. Continued investigation is likely to reveal new therapies such as citrulline and cinaciguat that will enhance NO synthase and soluble guanylate cyclase function. Continued laboratory and clinical investigation will be needed to optimize treatment and improve outcomes.

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“…Vasopressin, a systemic vasoconstrictor and pulmonary vasodilator, is a promising therapy for PH. Mohamed and colleagues administered vasopressin to 10 infants with PPHN for refractory hypotension and hypoxemia (50). All infants received inhaled NO prior to vasopressin.…”

Section: Right Ventricular Function In Pulmonary Hypertensionmentioning

confidence: 99%

Pulmonary Hypertension

Oishi

Fineman

2016

Pediatric Critical Care Medicine

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Objectives To review the clinical classification, diagnosis and pathophysiology of pulmonary hypertension in children, emphasizing the role of right ventricular function, ventricular interaction and congenital heart disease in the evolution and progression of disease, as well as management strategies and therapeutic options. Data Source MEDLINE, PubMed Conclusion Critically ill children with pulmonary hypertension associated with congenital heart disease are a high-risk population. Congenital cardiac defects resulting in either increased pulmonary blood flow or impaired pulmonary venous drainage predispose patients to developing structural and functional aberrations of the pulmonary vasculature. Mortality from pulmonary hypertension is most directly related to right ventricular failure.

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Vasopressin as a Rescue Therapy for Refractory Pulmonary Hypertension in Neonates

Cited by 74 publications

References 41 publications

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Advances in Neonatal Pulmonary Hypertension

Pulmonary Hypertension

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