Assuntos
Antiácidos/efeitos adversos , Doenças do Recém-Nascido/sangue , Magnésio/sangue , Antiácidos/administração & dosagem , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/prevenção & controle , Humanos , Recém-Nascido , Magnésio/efeitos adversos , Masculino , Tolazolina/efeitos adversosAssuntos
Síndrome do Desconforto Respiratório do Recém-Nascido/tratamento farmacológico , Tolazolina/uso terapêutico , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Humanos , Recém-Nascido , Síndrome do Desconforto Respiratório do Recém-Nascido/complicações , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidade , Tolazolina/efeitos adversosRESUMO
Thirty-nine critically ill infants with pulmonary disease received tolazoline because of severe hypoxemia refractory to administration of 100% O2 and mechanical ventilation. Twenty-seven (69%) of the infants responded with an increase in PaO2 greater than or equal to 20 torr in the first umbilical arterial gas after completion of the initial ten-minute infusion (1 to 2 mg/kg) of the drug. A response was not correlated with survival. The overall survival was 46%, essentially unchanged from our previous report (44%). Infants with hyaline membrane disease had the poorest survival rate (33%). Complications associated with the use of tolazoline occurred in 82% of the infants. A hypotensive reaction, defined as a 25% decrease in mean arterial pressure from the pre-tolazoline level, occurred in 67% of the infants, and more commonly in the infants with RDS (87%). In 11 infants who did not respond to the initial dose of tolazoline, the dose was increased up to 10 mg/kg/hour; only one infant responded, and eight (73%) had a hypotensive reaction.
Assuntos
Hipóxia/terapia , Doenças do Recém-Nascido/complicações , Pneumopatias/complicações , Tolazolina/uso terapêutico , Dióxido de Carbono/sangue , Humanos , Doença da Membrana Hialina/complicações , Doença da Membrana Hialina/mortalidade , Hipóxia/tratamento farmacológico , Hipóxia/etiologia , Recém-Nascido , Doenças do Recém-Nascido/mortalidade , Inalação , Pneumopatias/mortalidade , Mecônio , Oxigênio/sangue , Oxigenoterapia , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/complicações , Síndrome , Tolazolina/efeitos adversos , Artérias UmbilicaisRESUMO
Forty-six neonates with hypoxemia were treated with tolazoline, a pulmonary vasodilator, within the first two days of life. Eight of ten (80%) infants without apparent lung disease responded with a mean increase in PaO2 of 116 torr within one hour of beginning tolazoline infusions. One of the responding infants and two nonresponders died. Thirty-six additional infants with a variety of pulmonary disorders had severe hypoxemia which was refractory to mechanical ventilation. Twenty-one (58%) responded with a mean increase in PaO2 of 130 torr within one hour after beginning tolazoline and 13 (62%) of these survived. Fifteen patients had little or no improvement in PaO2 following tolazoline and only three (20%) of these infants survived. Responders could not be distinguished from nonresponders by clinical or laboratory features prior to therapy with tolazoline. Fourteen infants experienced complications possibly related to tolazoline.