Tolazoline and dopamine therapy in neonatal hypoxia and pulmonary vasospasm.

Severe hypoxia unresponsive to maximum ventilatory support occurs both in idiopathic respiratory distress syndrome and meconium aspiration. We recently encountered a 980 g female infant with respiratory distress syndrome and 3 300 g female infant with meconium aspiration and persistant fetal circulation whose clinical course necessitated the use of tolazoline and dopamine to reduce pulmonary and to stabilize systemic pressures. The infant with respiratory distress syndrome responded with a PaO2 increase of 2.7 kPa while the infant with persistant fetal circulation and meconium aspiration showed a 51.6 kPa rise. Combined pharmacologic therapy may have a role in improving oxygenation status in severely hypoxemic infants receiving maximum support.