| Low-dose vasopressin infusion therapy for refractory hypotension in ELBW infants. | |
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MedLine Citation:
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PMID: 19793209 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Severe hypotension in infants, especially in preterm infants, is associated with poor neurological outcome and high mortality. In adults, low-dose vasopressin (arginine vasopressin: AVP) infusion therapy has been effective for treating hypotension that is refractory to vasopressors and inotropes. METHODS: The effects of AVP infusion therapy for refractory hypotension were retrospectively evaluated in extremely low-birthweight infants. Between January 2002 and November 2005, 22 infants with refractory hypotension treated with low-dose AVP infusion were reviewed. The average birthweight was 658 g (+/-142 g), and the average gestational age was 24.9 weeks (+/-1.4). The changes in blood pressure, urinary output, and other parameters in response to AVP therapy were analyzed in all the infants. RESULTS: After AVP infusion, systolic blood pressure increased from 30 mmHg to 43 mmHg (P < 0.0001), and the diastolic pressure increased from 15 mmHg to 24 mmHg (P < 0.0001). The urine output dramatically increased from 1.5 mL/kg per h to 4.0 mL/kg per h (P < 0.0001). AVP infusion, however, was not effective in four of the 22 patients (18%). The sodium concentration in the serum decreased mildly after administration. In six patients the serum sodium concentration decreased below 130 mEq/L. Severe mitral regurgitation was observed in two patients. Three infants showed a transient decrease in the platelet count during AVP infusion. CONCLUSIONS: Low-dose AVP therapy should be considered as rescue therapy when high-dose catecholamine therapy and/or steroid administration do not produce sufficient increase in the blood pressure. Further investigations are required to prove the efficacy and safety of AVP infusion therapy in preterm infants. |
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Authors:
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Hitoshi Ikegami; Masahisa Funato; Hiroshi Tamai; Hiroshi Wada; Makoto Nabetani; Masato Nishihara |
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Publication Detail:
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Type: Journal Article Date: 2009-09-28 |
Journal Detail:
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Title: Pediatrics international : official journal of the Japan Pediatric Society Volume: 52 ISSN: 1442-200X ISO Abbreviation: Pediatr Int Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-12-13 Revised Date: 2011-09-01 |
Medline Journal Info:
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Nlm Unique ID: 100886002 Medline TA: Pediatr Int Country: Australia |
Other Details:
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Languages: eng Pagination: 368-73 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Yodogawa Christian Hospital, Osaka City, Osaka, Japan. a103146@ych.or.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arginine Vasopressin
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administration & dosage* Blood Pressure Determination Cohort Studies Dose-Response Relationship, Drug Drug Administration Schedule Drug Resistance Female Follow-Up Studies Humans Hypotension / diagnosis, drug therapy*, mortality* Infant, Extremely Low Birth Weight* Infant, Newborn Infant, Newborn, Diseases / drug therapy*, mortality* Infusions, Intravenous Intensive Care Units, Neonatal Male Retrospective Studies Risk Assessment Severity of Illness Index Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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113-79-1/Arginine Vasopressin |
| Comments/Corrections | |
Comment In:
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Pediatr Int. 2011 Apr;53(2):287
[PMID:
21501320
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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