Effects of tolvaptan on congestive heart failure complicated with chylothorax in a neonate.
Tolvaptan is an oral vasopressin type 2 receptor antagonist that can be used for heart failure patients with hyponatremia or symptomatic congestion. Although the effects of tolvaptan in adults have been well documented, only limited information is available in children. The case of a neonate with congestive heart failure complicated with chylothorax after palliative surgery for transposition of the great arteries treated with tolvaptan is reported. Slow up-titration to 0.1 mg/kg successfully increased urine output and improved refractory congestive heart failure without hypernatremia. Subsequently, bodyweight and chylothorax decreased gradually. Moreover, the use of tolvaptan reduced the dosage of furosemide. Tolvaptan could be an alternative drug for neonates with congestive heart failure. Further large studies are needed to confirm the efficacy and identify the appropriate dose of tolvaptan in neonates.
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Nikiko
N
Sato
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Tokio
T
Sugiura
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Rika
R
Nagasaki
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Kazutaka
K
Suzuki
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Koichi
K
Ito
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Takenori
T
Kato
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Sachiko
S
Inukai
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
Shinji
S
Saitoh
D000328:Adult; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use*; D001835:Body Weight; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007010:Hyponatremia; D007231:Infant, Newborn; D008297:Male; D013902:Radiography, Thoracic; D000077602:Tolvaptan; D014188:Transposition of Great Vessels / Q000150:complications* / Q000175:diagnosis
D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan
chylothorax; congestive heart failure; neonate; surgery for congenital heart disease; tolvaptan