Nicardipine to control mean arterial pressure during extracorporeal membrane oxygenation.
The authors present the use of nicardipine to control mean arterial pressure (MAP) in a 19-month-old boy who required venoarterial extracorporeal membrane oxygenation for 11 days for treatment of hydrocarbon aspiration. Nicardipine is an intravenously administered dihydropyridine calcium channel antagonist whose primary physiological action includes vasodilatation. Unlike other calcium channel blockers, it has limited effects on the inotropic and dromotropic function of the myocardium. Nicardipine was started at 5 micrograms.kg-1.min-1 and within five min lowered the MAP from a maximum value of 108 mmHg back to the baseline range of 60 to 80 mmHg. Once the MAP had returned to baseline values, infusion requirements varied from 1 to 3 micrograms.kg-1.min-1 to maintain the MAP at 60 to 80 mmHg during the 11 days of ECMO. No increase in dose requirements were noted during the 11 days.
Tobias
J D
JD
Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee, USA.
Pietsch
J B
JB
Lynch
A
A
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D006838:Hydrocarbons / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000628:therapy; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D006838:Hydrocarbons; D014665:Vasodilator Agents; D009529:Nicardipine