Vasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns

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dc.catalogadoraba
dc.contributor.authorSantelices Ruíz, Felipe
dc.contributor.authorMasoli, Daniela
dc.contributor.authorKattan Said, Alberto Javier
dc.contributor.authorToso, Alberto
dc.contributor.authorLuco Illanes, Matías Fernando
dc.date.accessioned2024-01-17T19:36:09Z
dc.date.available2024-01-17T19:36:09Z
dc.date.issued2022
dc.description.abstractAbstract Objective. The aim of our study is to describe the effects of vasopressin on term infants with persistent pulmonary hypertension under a standardized protocol. Study Design: In 2019, we designed a standardized protocol for the management of refractory hypotension in the context of pulmonary hypertension, which included the use of vasopressin. This is a retrospective cohort study to evaluate the clinical, laboratory, and echocardiographic outcomes of patients who required vasopressin in the context of this new protocol in a referral level IV neonatal intensive care unit. Results: We included 48 neonates with a median gestational age of 37 weeks in a period of 30 months (December 2019 to May 2022). Congenital diaphragmatic hernia was the main cause of persistent pulmonary hypertension in this cohort (82%). All patients were on mechanical ventilation and receiving inhaled nitric oxide. In our cohort at 4 hours after initiation of vasopressin, blood pressure, serum pH, and urinary output increased significantly. The vasoactive inotropic score, lactate and oxygenation index decreased. Echocardiographic follow-up also showed a decrease in the relative pressure of the right ventricle and an improvement in the cardiac output of both ventricles. There were no episodes of severe hyponatremia (<120 mmol/L). Discussion: This study showed that the use of vasopressin in neonates with persistent pulmonary hypertension and refractory systemic hypotension was associated with a rapid and significant improvement in oxygenation and hemodynamic markers of perfusion, including blood pressure. This association was early during the first hours of treatment and vasopressin was safely withdrawn after a median of 3 days of treatment.
dc.fechaingreso.objetodigital2024-01-19
dc.format.extent12 páginas
dc.fuente.origenORCID-ene24
dc.identifier.doi10.21203/rs.3.rs-2203038/v1
dc.identifier.eissn2693-5015
dc.identifier.urihttps://doi.org/10.21203/rs.3.rs-2203038/v1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/80595
dc.information.autorucEscuela de Medicina; Toso, Alberto; 0000-0002-3809-2567; 238020
dc.information.autorucEscuela de Medicina; Santelices Ruíz, Felipe; 0000-0002-9229-221X; 209536
dc.information.autorucEscuela de Medicina; Masoli, Daniela; S/I; 209537
dc.information.autorucEscuela de Medicina; Kattan Said, Alberto Javier; 0000-0002-2911-5982; 53324
dc.information.autorucEscuela de Medicina; Luco Illanes, Matías Fernando; 0000-0002-7698-8065; 7023
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final12
dc.pagina.inicio1
dc.revistaResearch Square
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 DEEDAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleVasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns
dc.typepreprint
sipa.codpersvinculados238020
sipa.codpersvinculados209536
sipa.codpersvinculados209537
sipa.codpersvinculados53324
sipa.codpersvinculados7023
sipa.trazabilidadORCID;2024-01-08
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