| Nitroglycerin Treatment in Persistent Pulmonary Hypertension of the Newborn |
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Ji Sook Kim, Sung Sook Jeon, Son Sang Seo |
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Department of Pediatrics, Il Sin Christian Hospital, Pusan, Korea |
| 신생아의 지속성 폐고혈압에서 Nitroglycerin의 치료 |
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김지숙, 전성숙, 서손상 |
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일신기독병원 소아과 |
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| Abstract |
Purpose
: Persistent pulmonary hypertension(PPHN) of the newborn has been treated
with some vasodilators including tolazoline. But these drugs have many side effects,
especially systemic hypotension . To investigate the usefulness of the nitroglycerin as a
specific vasodilator with few side effects, this study was done.
Methods
: Nitroglycerin was administered within 1st one day after birth in 8 newborn
infants who were diagnosed as PPHN by echocardiography. They were born at Il Sin
hospital from March 1994 to March 1996. Nitroglycerin was started as 2μg/kg/min and
its maximum dose was 6μg/kg/min. Muscle relaxants and inotropic drugs were used
together in all cases. Arterial blood gas analysis, systemic blood pressure, heart rate,
renal function and electrolyte were checked in all patients. Alveolar-arterial oxygen
difference(AaDO2) and oxygenation index(OI) were measured.
Results
: 6 cases(75%) survived but 2 cases expired due to air leak.
1) Basal mean AaDO2 was 631.4±21.7mmHg. It decreased to 493.9±1453.1 mmHg at
10hr after loading infusion and to 373.6±217.7mmHg at 48hr(P < 0.05).
2) Basal mean OI was 35.1±15.7 and it decreased significantly to 12.6±14.8(P < 0.05) at
10hr.
3) There was no significant hypotension in systolic, diastolic and mean blood pressure
during treatment of nitroglycerin.
4) There was no significant change in renal function, serum electrolyte and heart rate
during treatment of nitroglycerin.
Conclusions
: Nitroglycerin produced systemic venodilatation and pulmonary arterial
dilatation at the dose that produce only minimal systemic arterial dilatation. Nitroglycerin
is an effective and safe drug in the treatment of PPHN. |
| Key Words:
Nitroglycerin, Persistent pulmonary hypertension, New born |
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