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Hydralazine in infants with persistent hypoxemic respiratory failure
Atsushi Kawaguchi1, Tetsuya Isayama, Rintaro Mori
1Pediatrics, Pediatric Critical Care Medicine, University of Alberta, Edmonton, Canada. kawaguchi412@gmail.com
The Cochrane Database of Systematic Reviews
|March 2, 2013
Summary
No studies were found to evaluate hydralazine for persistent hypoxemic respiratory failure in premature infants. More research is needed to determine its safety and effectiveness in treating this condition.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Respiratory Medicine
Background:
- Infant deaths from chronic lung disease (CLD) often result from respiratory failure, pulmonary artery hypertension (PAH), or infection.
- PAH in infants with CLD is associated with high mortality, and effective treatments beyond oxygen are lacking.
- The efficacy and safety of vasodilators for PAH in premature infants with CLD remain largely unproven.
Purpose of the Study:
- To review existing evidence on the benefits and harms of hydralazine therapy for infants experiencing persistent hypoxemic respiratory failure.
Main Methods:
- A systematic search of major databases (Cochrane CENTRAL, PubMed, EMBASE) and clinical trials registries was conducted up to November 2011.
- Included studies were randomized controlled trials (RCTs) and quasi-RCTs involving low birth weight (LBW) infants with persistent hypoxemic respiratory failure treated with hydralazine.
- Trial quality was independently assessed by two reviewers.
Main Results:
- No studies met the inclusion criteria for this review, indicating a lack of available research on hydralazine for this specific infant population.
Conclusions:
- Insufficient evidence exists to confirm the safety and efficacy of hydralazine in LBW infants with persistent hypoxemic respiratory failure.
- Randomized controlled trials are recommended due to hydralazine's low cost and potential benefits.
- Further research is crucial, especially in resource-limited settings where alternatives like sildenafil, inhaled nitric oxide (iNO), or ECMO may not be accessible.
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