Endotracheal tolazoline administration in neonates with persistent pulmonary hypertension.
OBJECTIVE
Our purpose was to study the effectiveness of endotracheal tolazoline (ET-Tz) in the treatment of neonatal persistent pulmonary hypertension (PPHN).


METHODS
ET-Tz was administered to 12 neonates with a clinical diagnosis of PPHN. The gestational age ranged from 25 to 42 weeks, and the birth weights from 850 to 3612 gm. The dose of tolazoline ranged from 1 to 2.5 mg/kg.


RESULTS
There was a significant increase (p < 0.005) in the mean levels of oxygen saturation and the arterial oxygen tension, and a significant decrease (p < 0.005) in the oxygenation index, between the pretolazoline and the posttolazoline groups, but arterial carbon dioxide tension did not change. After the initial analysis, the groups were subdivided into preterm and term subgroups, because we secondarily observed that the average changes from predose to postdose levels in the above parameters were significantly different (p < 0.001) in the two subgroups by Student's paired t test.


CONCLUSIONS
The data indicate that ET-Tz is effective in improving oxygenation in neonates with PPHN, particularly sick preterm infants. The endotracheal route is preferred because it is devoid of significant side effects (e.g., hypotension and flushing). A randomized, controlled, double-blinded, multicenter trial for the use of ET-Tz in PPHN is warranted.
Parida
S K
SK
Division of Neonatology, University of Kentucky Medical Center, Lexington, USA.
Baker
S
S
Kuhn
R
R
Desai
N
N
Pauly
T H
TH
D000280:Administration, Inhalation; D001724:Birth Weight; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000188:drug therapy*; D012121:Respiration, Artificial; D014043:Tolazoline / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
D014665:Vasodilator Agents; D002245:Carbon Dioxide; D014043:Tolazoline