PMID- 32485754
OWN - NLM
STAT- MEDLINE
DCOM- 20220121
LR  - 20220121
IS  - 1098-8785 (Electronic)
IS  - 0735-1631 (Linking)
VI  - 38
IP  - 12
DP  - 2021 Oct
TI  - Effect of Vasopressin on Systemic and Pulmonary Hemodynamics in Neonates.
PG  - 1330-1334
LID - 10.1055/s-0040-1712999 [doi]
AB  - OBJECTIVE: Despite its increasing use in neonates, the literature on the use of 
      vasopressin (VP) in neonates is limited. The aim of this study is to evaluate the 
      systemic and pulmonary effects of VP in neonates and to assess its safety among 
      them. STUDY DESIGN: This retrospective study enrolled all neonates in two level 
      III neonatal intensive care units in Winnipeg, Manitoba, who had received VP 
      therapy between 2011 and 2016. Infants with congenital malformations/chromosomal 
      disorders were excluded. The changes in cardiovascular and pulmonary parameters 
      were collected from patient charts. The primary outcome was the mean blood 
      pressure (MBP) post-VP initiation. Secondary outcomes included systolic blood 
      pressure (SBP) and diastolic blood pressure (DBP), vasoactive inotropic score 
      (VIS), pH, urine output, lactate, base deficit (BD), mean airway pressure (MAP), 
      and oxygen requirement. RESULTS: A total of 33 episodes from 26 neonates were 
      analyzed. The postnatal age at VP initiation was 14 days (interquartile range 
      [IQR]: 4-25), and the median starting dose was 0.3 mU/kg/min (IQR: 0.2-0.5). MBP 
      improved significantly after VP initiation from 28 to 39 mm Hg 24 hours after VP 
      initiation (p < 0.001). Similar changes are observed with SBP and DBP. VIS 
      declined from 15 to 6 at 24 hours, while pH, lactate, BD, and oxygen requirement 
      improved significantly. While urine output marginally improved, there were no 
      changes to MAP 24 hours post-VP initiation. Hyponatremia was observed in 21 
      episodes (64%) and severe hyponatremia in 7 episodes (33%). CONCLUSION: VP 
      appears to be a promising rescue therapy in catecholamine resistant shock or 
      refractory pulmonary hypertension in neonates.
CI  - Thieme. All rights reserved.
FAU - Budniok, Thomas
AU  - Budniok T
AD  - Division of Neonatology, Department of Pediatrics and Child Health, Max Rady 
      Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
FAU - ElSayed, Yasser
AU  - ElSayed Y
AD  - Division of Neonatology, Department of Pediatrics and Child Health, Max Rady 
      Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
FAU - Louis, Deepak
AU  - Louis D
AD  - Division of Neonatology, Department of Pediatrics and Child Health, Max Rady 
      Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
LA  - eng
PT  - Journal Article
DEP - 20200602
PL  - United States
TA  - Am J Perinatol
JT  - American journal of perinatology
JID - 8405212
RN  - 0 (Vasoconstrictor Agents)
RN  - 11000-17-2 (Vasopressins)
SB  - IM
MH  - Blood Pressure/*drug effects
MH  - Female
MH  - Hemodynamics/*drug effects
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy
MH  - Hypotension/*drug therapy
MH  - Infant, Newborn
MH  - Infant, Newborn, Diseases/mortality
MH  - Lung/drug effects/physiology
MH  - Male
MH  - Retrospective Studies
MH  - Urine
MH  - Vasoconstrictor Agents/*pharmacology/therapeutic use
MH  - Vasopressins/*pharmacology/therapeutic use
COIS- None declared.
EDAT- 2020/06/03 06:00
MHDA- 2022/01/22 06:00
CRDT- 2020/06/03 06:00
PHST- 2020/06/03 06:00 [pubmed]
PHST- 2022/01/22 06:00 [medline]
PHST- 2020/06/03 06:00 [entrez]
AID - 10.1055/s-0040-1712999 [doi]
PST - ppublish
SO  - Am J Perinatol. 2021 Oct;38(12):1330-1334. doi: 10.1055/s-0040-1712999. Epub 2020 
      Jun 2.