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Pediatric Surgery International

Published in:

01-07-2018 | Original Article

Response to pulmonary vasodilators in infants with congenital diaphragmatic hernia

Authors: Vasantha H. S. Kumar, Rita Dadiz, Jamie Koumoundouros, Stephanie Guilford, Satyan Lakshminrusimha

Published in: Pediatric Surgery International | Issue 7/2018

Abstract

Background

Congenital diaphragmatic hernia (CDH) is associated with lung hypoplasia, cardiac dysfunction and pulmonary hypertension. Inhaled nitric oxide (iNO) and milrinone are commonly used pulmonary vasodilators in CDH. We studied the hemodynamic effects of iNO and milrinone in infants with CDH.

Methods

A retrospective chart review was performed of all CDH infants admitted to two regional perinatal centers and infants classified into three groups: No-iNO group; iNO-responders and iNO-nonresponders. Oxygenation and hemodynamic effects of iNO and milrinone were assessed by blood gases and echocardiography.

Results

Fifty-four percent (39/72) of infants with CDH received iNO and 31% of these infants (12/39) had complete oxygenation response to iNO. Oxygenation response to iNO was not associated with a decrease in right ventricular pressures (RVP) or ECMO use. Four infants (33%) in the iNO-responder group and eight infants (30%) in the iNO-nonresponder group received milrinone. Milrinone lowered RVP and improved ejection fraction (EF). Response to iNO was associated with improved oxygenation to milrinone and increased survival following ECMO (67 vs. 20% among nonresponders).

Conclusions

Response to inhaled nitric oxide in combination with milrinone may be associated with improved oxygenation and better survival after ECMO in infants with CDH.

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Title: Response to pulmonary vasodilators in infants with congenital diaphragmatic hernia
Authors: Vasantha H. S. Kumar
Rita Dadiz
Jamie Koumoundouros
Stephanie Guilford
Satyan Lakshminrusimha
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 7/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-018-4286-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Response to pulmonary vasodilators in infants with congenital diaphragmatic hernia

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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