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Preliminary experience with nesiritide in the pediatric population.
Julie Marshall1, John W Berkenbosch, Pierantonio Russo
1University of Missouri School of Medicine, Columbia, Missouri 65212, USA.
Journal of Intensive Care Medicine
|May 25, 2004
Summary
Nesiritide, a recombinant brain-type natriuretic factor, shows promise in pediatric heart failure. Early results in 5 infants and children suggest improved cardiac output and perfusion, even in complex cases.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Pharmacology
Background:
- Nesiritide, a recombinant brain-type natriuretic factor, is used for adult decompensated congestive heart failure.
- Its efficacy and safety in pediatric populations are not yet established.
- This study explores nesiritide's use in infants and children.
Observation:
- Retrospective review of 5 pediatric patients treated with nesiritide.
- Patients had diverse critical conditions including post-cardiothoracic surgery, ARDS, and septic shock recovery.
- Cardiac output was not directly measured, but surrogate markers were assessed.
Findings:
- Improved peripheral perfusion, extremity warming, and enhanced peripheral pulses observed in all patients.
- Increased venous oxygen saturation in 2 patients.
- Maintained or increased urine output despite diuretic weaning/discontinuation.
Implications:
- Nesiritide may improve hemodynamic status in critically ill children.
- Further research is warranted to confirm efficacy and safety in pediatric patients.
- Potential role for nesiritide in managing pediatric heart failure and other critical conditions.