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Titolo:
ADENOSINE INFUSION IMPROVES OXYGENATION IN TERM INFANTS WITH RESPIRATORY-FAILURE
Autore:
KONDURI GG; GARCIA DC; KAZZI NJ; SHANKARAN S;
Indirizzi:
HUTZEL HOSP,DEPT PEDIAT,4707 ST ANTOINE BLVD DETROIT MI 48201 CHILDRENS HOSP MICHIGAN,DEPT PEDIAT DETROIT MI 48201 WAYNE STATE UNIV,SCH MED,DEPT PEDIAT DETROIT MI 48201
Titolo Testata:
Pediatrics
fascicolo: 3, volume: 97, anno: 1996,
pagine: 295 - 300
SICI:
0031-4005(1996)97:3<295:AIIOIT>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERSISTENT PULMONARY-HYPERTENSION; INHALED NITRIC-OXIDE; FETAL LAMBS; TOLAZOLINE; NEWBORN; TRIPHOSPHATE; CIRCULATION; VASODILATOR; METABOLISM; HYPOXEMIA;
Keywords:
ADENOSINE; OXYGENATION; PERSISTENT PULMONARY HYPERTENSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
G.G. Konduri et al., "ADENOSINE INFUSION IMPROVES OXYGENATION IN TERM INFANTS WITH RESPIRATORY-FAILURE", Pediatrics, 97(3), 1996, pp. 295-300

Abstract

Objective. Adenosine infusion causes selective pulmonary vasodilationin fetal and neonatal lambs with pulmonary hypertension. We investigated the,effects of a continuous infusion of adenosine on oxygenation in term infants with persistent pulmonary hypertension of newborn (PPHN). Design. A randomized, placebo-controlled, masked trial comparing the efficacy of intravenous infusion of adenosine to normal saline infusion over a 24-hour period. Setting. Inborn and outborn level III neonatal intensive care units at a university medical center. Participants. Eighteen term infants with PPHN and arterial postductal Po-2 of 60 to100 Torr on inspired O-2 concentration of 100% and optimal hyperventilation (PaCo2 <30 Torr) were enrolled into the study. Study infants were randomly assigned to receive a placebo infusion of normal saline, or adenosine infusion in doses of 25 to 50 mu g/kg/min over a 24-hour period. Results. Nine infants each received adenosine or placebo. The two groups did not differ in birth weight, gestational age, or blood gases and ventilator requirements at the time of entry into the study. Four of nine infants in the adenosine group and none of the placebo group had a significant improvement in oxygenation, defined as an increase in postductal Pao(2) of greater than or equal to 20 Torr from preinfusion baseline. The mean Pao(2) in the adenosine group increased from 69 +/- 19 at baseline to 94 +/- 15 during 50 mu g/kg/min infusion rateof adenosine and did not change significantly in the placebo group. Arterial blood pressure and heart rate did not change during the study in either group. The need for extracorporeal membrane oxygenation, incidence of bronchopulmonary dysplasia, and mortality were not differentin the two groups. Conclusion. Data from this pilot study indicate that adenosine infusion at a dose of 50 mu g/kg/min improves Pao, in infants with PPHN without causing hypotension or tachycardia. Larger trials are needed to determine its effects on mortality and/or need for extracorporeal membrane oxygenation in infants with PPHN.

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Documento generato il 09/04/20 alle ore 07:50:27