The Annals of pharmacotherapy · 2003
Nicardipine to control neonatal hypertension during extracorporeal membrane oxygen support.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
McBride Brian F, White C Michael, Campbell Margaret, Frey Bruce M
Аннотация
OBJECTIVE: To describe the clinical course of a newborn (gestational age 38 wk, 6 d) administered intravenous nicardipine to control hypertension while on extracorporeal membrane oxygen (ECMO) support.
SETTING: Urban, university teaching hospital.
CASE SUMMARY: A 1-day-old male neonate presenting with a left congenital diaphragmatic hernia developed a sustained elevation in blood pressure following a change of ECMO tubing. After several unsuccessful treatment regimens, nicardipine was started at a rate of 0.5 micro g/kg/min and aggressively titrated to 1.5 micro g/kg/min. Nicardipine produced a sustained antihypertensive effect that was noticed 8 hours after the start of the infusion. The infusion was continued through postoperative day 2. Following a second circuit change, nicardipine was discontinued and sodium nitroprusside therapy was started. Treatment with nitroprusside failed to lower the blood pressure.
DISCUSSION: Nicardipine is an effective antihypertensive agent for neonates receiving ECMO therapy. However, the expanded volume of distribution caused by the ECMO circuit may result in a reduced serum concentration and a reduced antihypertensive effect.
CONCLUSIONS: We recommend a conservative initial dose of nicardipine of 0.5 micro g/kg/min that is aggressively titrated to reduce blood pressure effectively in neonates receiving ECMO therapy.
SETTING: Urban, university teaching hospital.
CASE SUMMARY: A 1-day-old male neonate presenting with a left congenital diaphragmatic hernia developed a sustained elevation in blood pressure following a change of ECMO tubing. After several unsuccessful treatment regimens, nicardipine was started at a rate of 0.5 micro g/kg/min and aggressively titrated to 1.5 micro g/kg/min. Nicardipine produced a sustained antihypertensive effect that was noticed 8 hours after the start of the infusion. The infusion was continued through postoperative day 2. Following a second circuit change, nicardipine was discontinued and sodium nitroprusside therapy was started. Treatment with nitroprusside failed to lower the blood pressure.
DISCUSSION: Nicardipine is an effective antihypertensive agent for neonates receiving ECMO therapy. However, the expanded volume of distribution caused by the ECMO circuit may result in a reduced serum concentration and a reduced antihypertensive effect.
CONCLUSIONS: We recommend a conservative initial dose of nicardipine of 0.5 micro g/kg/min that is aggressively titrated to reduce blood pressure effectively in neonates receiving ECMO therapy.