Portal de Periódicos da CAPES

Refractory hypoxemia associated with neonatal pulmonary disease: The use and limitations of tolazoline

1979; Elsevier BV; Volume: 95; Issue: 4 Linguagem: Inglês

10.1016/s0022-3476(79)80777-5

1097-6833

David K. Stevenson, David S. Kasting, Robert A. Darnall, Ronald L. Ariagno, John D. Johnson, Natalie Malachowski, Carrie L. Beets, Philip Sunshine,

Neonatal Health and Biochemistry

Thirty-nine critically ill infants with pulmonary disease received tolazoline because of severe hypoxemiarefractory to administration of 100% O2 and mechanical ventilation. Twenty-seven (69%) of the infants responded with an increase in PaO2≥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. Thirty-nine critically ill infants with pulmonary disease received tolazoline because of severe hypoxemiarefractory to administration of 100% O2 and mechanical ventilation. Twenty-seven (69%) of the infants responded with an increase in PaO2≥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.