Abstract
Objective
To determine the effect of vasopressin on arterial blood pressure in infants with neonatal hypertrophic obstructive cardiomyopathy (HOCM).
Study design
Retrospective case study in Neonatal ICU involving six infants; five born to mothers with diabetes mellitus (mean gestational age 37.5 ± 0.9 weeks). Vasopressin infusion was started at a mean dose of 0.3 ± 0.2 mU/kg/min.
Result
Initiation of vasopressin was followed by improved mean (p = 0.004), systolic (p = 0.028), and diastolic (p = 0.009) arterial pressure within 2 h. Heart rate (p = 0.025) and oxygen requirement (p = 0.021) also declined after initiation. Serum sodium declined initially and recovered by 72 h (p = 0.017).
Conclusion
Although there is limited experience with vasopressin use in neonatal HOCM, our case series suggests it may be beneficial for improving systemic hypotension and stabilization of hemodynamics. The potential for hyponatremia is high, necessitating careful fluid/electrolyte management. A prospective randomized trial is necessary to confirm safety and efficacy of vasopressin treatment in neonatal HOCM.
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Acknowledgements
Dr. Carlos Zozaya, Clinical Fellow in Neonatology at The Hospital for Sick Children, Canada, for his assistance with data collection for the study.
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PJM designed the study. SMB and KLR undertook data collection. SMB and REG processed the data and performed the analysis and interpretation. REG and PJM designed the figures. SMB wrote the draft manuscript. All authors participated in revision of the manuscript and approved the final manuscript for publication.
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Boyd, S.M., Riley, K.L., Giesinger, R.E. et al. Use of vasopressin in neonatal hypertrophic obstructive cardiomyopathy: case series. J Perinatol 41, 126–133 (2021). https://doi.org/10.1038/s41372-020-00824-7
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DOI: https://doi.org/10.1038/s41372-020-00824-7
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