Effect of tolazoline on persistent hypoxemia in severe hyaline membrane disease.
Ten critically-ill preterm infants with severe hyaline membrane disease received tolazoline because of persistent hypoxemia refractory to the administration of 100% oxygen and mechanical ventilation. Seven infants (70%) responded immediately with an increase in PaO2 greater than or equal to 20 mmHg in the umbilical arterial gas within 60 minutes after bolus infusion (1 to 2 mg/kg) of tolazoline. Twenty-four hours later after the tolazoline infusion, the FiO2 had been decreased from 1.0 to a mean of 0.82 +/- 0.16, and the MAP from 16.5 +/- 1.8 to 15.6 +/- 4.5 cm H2O. Four of 7 infants (57%) who had an immediate response survived, whereas none survived out of 3 infants who failed to respond initially. Three infants experienced relatively severe complications possibly related to tolazoline. There appears to be a place for the use of tolazoline in a severely hypoxemic infant with hyaline membrane disease who is being ventilated, and in whom arterial oxygenation cannot be improved by a further increase in the inspired oxygen concentration or by an alteration of ventilator settings.
Park
K I
KI
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Namgung
R
R
Lee
C
C
Han
D G
DG
D006801:Humans; D006819:Hyaline Membrane Disease / Q000150:complications*; D000860:Hypoxia / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D014043:Tolazoline / Q000008:administration & dosage / Q000627:therapeutic use*
D014043:Tolazoline