Vasopressin infusion therapy for refractory hypotension in extremely low birthweight neonates.

摘要

We read with great interest the paper by Hitoshi Ikegami and co-workers on the use of vasopressin for catecholamine-refractory hypotension in extremely low birthweight (ELBW) neonates, mostly of septic, but also of cardiac origin.1 The authors are to be congratulated on their work as this report is by far the largest study on the use of vasopressin in ELBW infants. However, contrary to the authors' notion there have been previous reports on the use of vasopressin in extremely premature neonates.2 Moreover, the term "low-dose vasopressin" is somewhat misleading as the doses used by Hitoshi Ikegami and co-workers (maximum doses of up to 0.02 U/kg/min) are clearly in excess of the recommended dose (0.002 U/kg/min).3 Comparably to our experience, the authors noticed a rapid increase in blood pressure and an increase in urine output. Of importance, overall survival was promising in their report.