Abstract
Infants with acute heart failure due to perinatal asphyxia may have elevation of systemic blood pressure from adrenergic stimulation. This afterload elevation is probably deleterious for myocardial function and tissue perfusion. Treatment needs to be directed towards increasing cardiac contractility and reducing afterload. Dopamine and chlorpromazine were given at 2-8 and 1-2 ugm/kg/min respectively, to 6 preterm infants with hypertension following severe perinatal asphyxia. This therapy improved hemo-dynamics in all infants: the heart rate did not increase significantly, mean arterial pressure decreased from 52±4 to 46±4, and skin PCO2, obtained with an unheated electrode, decreased by 8%. These results suggest that improvement in hemodynamics and tissue perfusion occurred without production of myocardial stress by tachycardia or hypotension. The use of an inotropic agent alone for heart failure in the presence of hypertension, may worsen the condition. The combination of dopamine, inotropic and moderate chronotropic agent with chlorpromazine, rapidly active, short acting vasodilator, successfully treated acute hypertension and transient left ventricular dysfunction. The association of hypertension and heart failure in asphyxiated preterm infants may be neurogenic or of vascular origin. In both, appropriate choice of therapy may be significant determinor of outcome.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
