title: Perioperative effects and safety of nesiritide following cardiac surgery in children.
abstract: Nesiritide (Natrecor, Scios Inc), human B-type natriuretic peptide, has hemodynamic effects that may be beneficial in pediatric patients after cardiac surgery. Experience with nesiritide and pediatrics is limited. The purpose of this study was to evaluate perioperative effects and safety of nesiritide in pediatric cardiothoracic surgery. Seventeen patients with congenital heart disease undergoing cardiac surgery were given a loading dose (1 microg/kg) while on cardiopulmonary bypass (constant flow) followed by continuous infusion for 24 hours (0.01 microg/kg/min x 6 hours, then 0.02 microg/kg/min x 18 hours). A 7% decrease in mean blood pressure was seen following nesiritide loading dose on cardiopulmonary bypass. No patient required intervention for hypotension while receiving nesiritide load or infusion. Nesiritide load during surgery and continuous infusion after cardiac surgery in pediatric patients resulted in no significant hemodynamic compromise.
authors.affiliation: Heart Care International, Santo Domingo, Dominican Republic. simsicj@kidsheart.com
authors.forename: Janet M
authors.initials: JM
authors.lastname: Simsic
authors.forename: Mark
authors.initials: M
authors.lastname: Scheurer
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
authors.forename: John
authors.initials: J
authors.lastname: Berkenbosch
authors.forename: William
authors.initials: W
authors.lastname: Schechter
authors.forename: Freddie
authors.initials: F
authors.lastname: Madera
authors.forename: Samuel
authors.initials: S
authors.lastname: Weinstein
authors.forename: Robert E
authors.initials: RE
authors.lastname: Michler
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D045283:Natriuretic Agents / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D019990:Perioperative Care / Q000379:methods; D013771:Tetralogy of Fallot / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain