Skip to main content
Top
Published in: Pediatric Cardiology 3/2007

01-06-2007 | CASE REPORT

Nesiritide for the Treatment of Pulmonary Hypertension and Cor Pulmonale in an Infant

Authors: E. W. Reynolds, E. T. Conely, M. Vranicar

Published in: Pediatric Cardiology | Issue 3/2007

Login to get access

Abstract

Nesiritide is a synthetic form of B-type natriuretic peptide. It is approved for the treatment of acute exacerbations of congestive heart failure in hospitalized adult patients. It is currently under investigation for use in other settings and other patient populations. This article describes administration of nesiritide to an infant patient with severe pulmonary hypertension and cor pulmonale. No adverse reactions occurred during administration of the drug. Specifically, there was no hypertension, vomiting, arrhythmia, or changes in renal function. No changes in renal function occurred in the months subsequent to treatment. This case report illustrates that nesiritide can be safely administered to critically ill infants with pulmonary hypertension and cor pulmonale. Our patient experienced a decrease in pulmonary pressure and improved clinical condition during and after the infusion. However, further study is required to fully evaluate the safety and efficacy of nesiritide for these patients.
Literature
1.
go back to reference Cargill RI, Lipworth BJ (1996) Atrial natriuretic peptide and brain natriuretic peptide in cor pulmonale. Chest 110:1220–1225PubMed Cargill RI, Lipworth BJ (1996) Atrial natriuretic peptide and brain natriuretic peptide in cor pulmonale. Chest 110:1220–1225PubMed
2.
go back to reference Feingold B, Law YM (2004) Nesiritide use in pediatric patients with congestive heart failure. J Heart Lung Transplant 23:1455–1459PubMedCrossRef Feingold B, Law YM (2004) Nesiritide use in pediatric patients with congestive heart failure. J Heart Lung Transplant 23:1455–1459PubMedCrossRef
3.
go back to reference Flynn PA, da Graca RL, Auld PA, Nesin M, Kleinman CS (2005) The use of a bedside assay for plasma B-type natriuretic peptide as a biomarker in the management of patent ductus arteriosus in premature neonates. J Pediatr 147:38–42PubMedCrossRef Flynn PA, da Graca RL, Auld PA, Nesin M, Kleinman CS (2005) The use of a bedside assay for plasma B-type natriuretic peptide as a biomarker in the management of patent ductus arteriosus in premature neonates. J Pediatr 147:38–42PubMedCrossRef
4.
go back to reference Itoh H, Pratt RE, Dzau VJ (1990) Atrial natriuretic polypeptide inhibits hypertrophy of vascular smooth muscle cells. J Clin Invest 86:1690–1697PubMedCrossRef Itoh H, Pratt RE, Dzau VJ (1990) Atrial natriuretic polypeptide inhibits hypertrophy of vascular smooth muscle cells. J Clin Invest 86:1690–1697PubMedCrossRef
5.
go back to reference Kunii Y, Kamada M, Ohtsuki S, et al. (2003) Plasma brain natriuretic peptide and the evaluation of volume overload in infants and children with congenital heart disease. Acta Med Okayama 57:191–197PubMed Kunii Y, Kamada M, Ohtsuki S, et al. (2003) Plasma brain natriuretic peptide and the evaluation of volume overload in infants and children with congenital heart disease. Acta Med Okayama 57:191–197PubMed
6.
go back to reference Mahle WT, Cuadrado AR, Kirshbom PM, Kanter KR, Simsic JM (2005) Nesiritide in infants and children with congestive heart failure. Pediatr Crit Care Med 6:543–546PubMedCrossRef Mahle WT, Cuadrado AR, Kirshbom PM, Kanter KR, Simsic JM (2005) Nesiritide in infants and children with congestive heart failure. Pediatr Crit Care Med 6:543–546PubMedCrossRef
7.
go back to reference Marshall J, Berkenbosch JW, Russo P, Tobias JD (2004) Preliminary experience with nesiritide in the pediatric population. J Intensive Care Med 19:164–170PubMedCrossRef Marshall J, Berkenbosch JW, Russo P, Tobias JD (2004) Preliminary experience with nesiritide in the pediatric population. J Intensive Care Med 19:164–170PubMedCrossRef
8.
go back to reference Mathews B, Russel JA, Steinhorn RH, et al. (2006) B-type natriuretic peptide (BNP) system in an ovine model of persistent pulmonary hypertension of the newborn (PPHN). PAS 59:3875.6 [Abstract] Mathews B, Russel JA, Steinhorn RH, et al. (2006) B-type natriuretic peptide (BNP) system in an ovine model of persistent pulmonary hypertension of the newborn (PPHN). PAS 59:3875.6 [Abstract]
9.
go back to reference Moffett BS, Chang AC (2006) Future pharmacologic agents for treatment of heart failure in children. Pediatr Cardiol 27:533–551PubMedCrossRef Moffett BS, Chang AC (2006) Future pharmacologic agents for treatment of heart failure in children. Pediatr Cardiol 27:533–551PubMedCrossRef
10.
go back to reference Moffett BS, Jefferies JL, Rossano J, Towbin JA (2006) Nesiritide therapy in a term neonate with renal disease. Pharmacotherapy 26:281–284PubMedCrossRef Moffett BS, Jefferies JL, Rossano J, Towbin JA (2006) Nesiritide therapy in a term neonate with renal disease. Pharmacotherapy 26:281–284PubMedCrossRef
11.
go back to reference Reynolds EW, Ellington JG, Vranicar M, Bada HS (2004) Brain-type natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension. Pediatrics 114:1297–1304PubMedCrossRef Reynolds EW, Ellington JG, Vranicar M, Bada HS (2004) Brain-type natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension. Pediatrics 114:1297–1304PubMedCrossRef
12.
go back to reference Sackner-Bernstein JD, Kowalski M, Fox M, Aaronson K (2005) Short-term risk of death after treatment with nesiritide for decompensated heart failure: a pooled analysis of randomized controlled trials. J Am Med Assoc 293:1900–1905CrossRef Sackner-Bernstein JD, Kowalski M, Fox M, Aaronson K (2005) Short-term risk of death after treatment with nesiritide for decompensated heart failure: a pooled analysis of randomized controlled trials. J Am Med Assoc 293:1900–1905CrossRef
13.
go back to reference Sackner-Bernstein JD, Skopicki HA, Aaronson KD (2005) Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure. Circulation 111:1487–1491PubMedCrossRef Sackner-Bernstein JD, Skopicki HA, Aaronson KD (2005) Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure. Circulation 111:1487–1491PubMedCrossRef
14.
go back to reference Sanjeev S, Pettersen M, Lua J, et al. (2005) Role of plasma B-type natriuretic peptide in screening for hemodynamically significant patent ductus arteriosus in preterm neonates. J Perinatol 25:709–713PubMedCrossRef Sanjeev S, Pettersen M, Lua J, et al. (2005) Role of plasma B-type natriuretic peptide in screening for hemodynamically significant patent ductus arteriosus in preterm neonates. J Perinatol 25:709–713PubMedCrossRef
15.
go back to reference Schamberger MS (2004) Is there a use for nesiritide in pediatric patients? J Intensive Care Med 19:171–173PubMedCrossRef Schamberger MS (2004) Is there a use for nesiritide in pediatric patients? J Intensive Care Med 19:171–173PubMedCrossRef
16.
go back to reference Sehra R, Underwood K (2006) Nesiritide use for critically ill children awaiting cardiac transplant. Pediatr Cardiol 27:47–50PubMedCrossRef Sehra R, Underwood K (2006) Nesiritide use for critically ill children awaiting cardiac transplant. Pediatr Cardiol 27:47–50PubMedCrossRef
17.
go back to reference Tammela OK, Koivisto ME (1992) A 1-year follow-up of low birth weight infants with and without bronchopulmonary dysplasia: health, growth, clinical lung disease, cardiovascular and neurological sequelae. Early Human Dev 30:109–120CrossRef Tammela OK, Koivisto ME (1992) A 1-year follow-up of low birth weight infants with and without bronchopulmonary dysplasia: health, growth, clinical lung disease, cardiovascular and neurological sequelae. Early Human Dev 30:109–120CrossRef
18.
go back to reference Thierry S, Lecuyer L, Brocas E, et al. (2006) Interest of the brain natriuretic peptide as a marker of acute cor pulmonale in acute respiratory distress syndrome. Ann Fr Anesth Reanim 25:815–819PubMed Thierry S, Lecuyer L, Brocas E, et al. (2006) Interest of the brain natriuretic peptide as a marker of acute cor pulmonale in acute respiratory distress syndrome. Ann Fr Anesth Reanim 25:815–819PubMed
19.
go back to reference Yap LB (2004) B-type natriuretic peptide and the right heart. Heart Failure Rev 9:99–105CrossRef Yap LB (2004) B-type natriuretic peptide and the right heart. Heart Failure Rev 9:99–105CrossRef
20.
go back to reference Yap LB, Mukerjee D, Timmms PM, Ashrafian H, Coghlan JG (2004) Natriuretic peptides, respiratory disease, and the right heart. Chest 126:1330–1336PubMedCrossRef Yap LB, Mukerjee D, Timmms PM, Ashrafian H, Coghlan JG (2004) Natriuretic peptides, respiratory disease, and the right heart. Chest 126:1330–1336PubMedCrossRef
Metadata
Title
Nesiritide for the Treatment of Pulmonary Hypertension and Cor Pulmonale in an Infant
Authors
E. W. Reynolds
E. T. Conely
M. Vranicar
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Pediatric Cardiology / Issue 3/2007
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-006-0064-6

Other articles of this Issue 3/2007

Pediatric Cardiology 3/2007 Go to the issue