Effects of intravenous nitroglycerin on hemodynamics in neonates with refractory congestive heart failure or PFC.

(1) Continuous intravenous infusion (2-10 micrograms/kg/min) of nitroglycerin (TNG) was administered to 20 neonates consisting of 17 with refractory congestive heart failure and 3 with PFC (Persistent Fetal Circulation). (2) At doses of 2-4 micrograms/kg/min, there were no significant changes in heart rate or systemic blood pressure. (3) At doses of 2-4 micrograms/kg/min, the CVP was significantly reduced and urinary output increased. (4) Echocardiograms revealed a significant decrease in LVS at 4-5 micrograms/kg/min. In addition, the EF and cardiac output were significantly increased at 2-5 micrograms/kg/min. (5) The right ventricle systolic time interval (STI) was reduced significantly at 2 micrograms/kg/min. The left ventricle STI was not reduced below doses of 4 micrograms/kg/min. (6) In the dose range 2-5 micrograms/kg/min, TNG is an effective and safe vasodilator in the treatment of refractory congestive heart failure or PFC in neonates.