TREATMENT OF SEVERE PERSISTENT PULMONARY-HYPERTENSION OF THE NEWBORN WITH MAGNESIUM-SULFATE

被引:56
作者
ABUOSBA, YK [1 ]
GALAL, O [1 ]
MANASRA, K [1 ]
REJJAL, A [1 ]
机构
[1] DHAHRAN HLTH CTR, DHAHRAN, SAUDI ARABIA
来源
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 1992年 / 67卷 / 01期
关键词
D O I
10.1136/adc.67.1_Spec_No.31
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Eight of nine newborn infants with severe persistent pulmonary hypertension of the newborn (PPHN), and a predicted mortality of 100%, and one infant with a predicted mortality > 94% based on alveolar-arterial oxygen tension difference ((A-a)Do2) were treated with magnesium sulphate (MgSO4) as a life saving therapy after they failed to improve with conventional treatment. Magnesium at high serum concentrations decreases pulmonary pressures and is a muscle relaxant and sedative. Diluted MgSO4.7H2O solution (200 mg/kg) was given intravenously over 20-30 minutes. No changes in the treatment were made after MgSO4. Mean serum magnesium concentration was maintained between 2.88 and 5.67 mmol/l by continuous intravenous infusion (six infants). Baseline arterial oxygen tension (PaO2) and haemoglobin oxygen saturation had mean (SD) values of 4.66 (1.8) kPa and 60.4 (29.7)% respectively, which started to increase one hour after MgSO4 infusion, and increased significantly at six hours to 12.04 (7.07) kPa and 91.8 (10.88)% respectively. Arterial carbon dioxide tension (PaCO2) decreased and pH increased significantly after one hour compared with the baseline value. PaO2 increases are probably secondarY to a decrease in pulmonary vascular resistance and pressure, decrease in a right to left shunt, better ventilation:perfusion ratio, and PaCO2 decrease and pH rise. Seven infants survived (77.8%). These results demonstrate the beneficial effect of magnesium in the management of PPHN when other accepted treatment fails, is contraindicated, or not available.
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页码:31 / 35
页数:5
相关论文
共 43 条
[31]  
Pritchard JA, 1985, HYPERTENSIVE DISORDE, P525
[32]   NEURO-BEHAVIORAL EFFECTS OF NEONATAL HYPERMAGNESEMIA [J].
RASCH, DK ;
HUBER, PA ;
RICHARDSON, CJ ;
LHOMMEDIEU, CS ;
NELSON, TE ;
REDDI, R .
JOURNAL OF PEDIATRICS, 1982, 100 (02) :272-276
[33]  
ROBERTS RJ, 1984, DRUG THERAPY INFANTS, P192
[34]   EXTRACORPOREAL MEMBRANE-OXYGENATION IN THE MANAGEMENT OF RESPIRATORY-FAILURE IN THE NEWBORN [J].
SHORT, BL ;
MILLER, MK ;
ANDERSON, KD .
CLINICS IN PERINATOLOGY, 1987, 14 (03) :737-748
[35]  
STONE SR, 1970, OBSTET GYNECOL, V35, P574
[36]  
TURPLAPATY PD, 1978, EUR J PHARMACOL, V52, P421
[37]   MILD HYPOTHERMIA AND MG++ PROTECT AGAINST IRREVERSIBLE DAMAGE DURING CNS ISCHEMIA [J].
VACANTI, FX ;
AMES, A .
STROKE, 1984, 15 (04) :695-698
[38]   MAGNESIUM-SULFATE - RATIONALE FOR ITS USE IN PREECLAMPSIA [J].
WATSON, KV ;
MOLDOW, CF ;
OGBURN, PL ;
JACOB, HS .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1986, 83 (04) :1075-1078
[39]   THE INFLUENCE OF MONO-VALENT AND DIVALENT-CATIONS ON THE CARDIAC METABOLISM OF ARACHIDONIC-ACID [J].
WEIS, MT ;
MALIK, KU .
PROSTAGLANDINS, 1989, 37 (06) :707-723
[40]   CALCIUM BLOCKERS IN CEREBRAL RESUSCITATION [J].
WHITE, BC ;
WINEGAR, CD ;
WILSON, RF ;
KRAUSE, GS .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1983, 23 (09) :788-794