Treatment of severe persistent pulmonary hypertension of the newborn with magnesium sulphate.
نویسندگان
چکیده
Eight of nine newborn infants with severe persistent pulmonary hypertension of the newborn (PPHN), and a predicted mortality of 100%, and one infant with a predicted mortality greater than 94% based on alveolar-arterial oxygen tension difference [A-a)DO2) were treated with magnesium sulphate (MgSO4) as a life saving therapy after they failed to improve with conventional treatment. Magnesium at high serum concentrations decreases pulmonary pressures and is a muscle relaxant and sedative. Diluted MgSO4.7H2O solution (200 mg/kg) was given intravenously over 20-30 minutes. No changes in the treatment were made after MgSO4. Mean serum magnesium concentration was maintained between 2.88 and 5.67 mmol/l by continuous intravenous infusion (six infants). Baseline arterial oxygen tension (PaO2) and haemoglobin oxygen saturation had mean (SD) values of 4.66 (1.8) kPa and 60.4 (29.7)% respectively, which started to increase one hour after MgSO4 infusion, and increased significantly at six hours to 12.04 (7.07) kPa and 91.8 (10.88)% respectively. Arterial carbon dioxide tension (PaCO2) decreased and pH increased significantly after one hour compared with the baseline value. PaO2 increases are probably secondary to a decrease in pulmonary vascular resistance and pressure, decrease in a right to left shunt, better ventilation:perfusion ratio, and PaCO2 decrease and pH rise. Seven infants survived (77.8%). These results demonstrate the beneficial effect of magnesium in the management of PPHN when other accepted treatment fails, is contraindicated, or not available.
منابع مشابه
The role of magnesium sulphate in the treatment of persistent pulmonary hypertension of the newborn.
متن کامل
Magnesium sulphate as an alternative and safe treatment for severe persistent pulmonary hypertension of the newborn.
Eleven newborns admitted consecutively to the neonatal unit with respiratory failure and severe persistent pulmonary hypertension (PPHN) were included in a clinical trial to assess the efficacy of magnesium sulphate (MgSO4) in the treatment of PPHN. A loading dose of 200 mg/kg MgSO4 was given over 20 minutes, followed by a continuous infusion of 20-150 mg/kg/hour to obtain a magnesium blood con...
متن کاملTreatment of seyere persistent pulmonary hypertension of the newborn with magnesium sulphate
Eight of nine newborn infants with severe persistent pulmonary hypertension of the newborn (PPHN), and a predicted mortality of 100%, and one infant with a predicted mortality >94% based on alveolar-arterial oxygen tension difference ((A-a)Do2) were treated with magnesium sulphate (MgSO4) as a life saving therapy after they failed to improve with conventional treatment. Magnesium at high serum ...
متن کاملA comparison of magnesium sulphate and sildenafil in the treatment of the newborns with persistent pulmonary hypertension: a randomized controlled trial.
The aim of this prospective, randomized and controlled study was to compare the clinical efficacy of intravenous magnesium sulfate (MgSO₄) and oral sildenafil therapies with persistent pulmonary hypertension of the newborn. A total of 34 infants in the MgSO₄ group and 31 infants in the sildenafil group completed the study. The time to reach the adequate clinical response [defined as oxygen inde...
متن کاملRole of magnesium sulphate in treatment of severe persistent pulmonary hypertension of the neoborn.
OBJECTIVE Treatment of severe persistent pulmonary hypertension of the neoborn remains controversial and various modalities of treatment have been tried. This study was performed to evaluate the effect of magnesium sulphate (MgSO4) as a treatment of persistent pulmonary hypertension of the neoborn (PPHN) in full term babies. METHODS This study was carried out in the Maternity and Children's H...
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ورودعنوان ژورنال:
- Archives of disease in childhood
دوره 67 1 Spec No شماره
صفحات -
تاریخ انتشار 1992