{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:12:42Z","timestamp":1792113162811,"version":"4.4.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Objective\u2003Persistent pulmonary hypertension of the newborn (PPHN) is a serious cardiorespiratory problem. PPHN is frequently associated with refractory hypoxia and hypotension, and optimal management has the potential to improve important clinical outcomes including mortality. The primary objective is to evaluate the efficacy and safety of rescue vasopressin (VP) therapy in the management of severe (refractory) hypoxia and refractory systemic hypotension in term neonates with severe PPHN.<\/jats:p>\n                  <jats:p>Study Design\u2003Neonates with refractory hypoxia and refractory hypotension due to severe PPHN needing VP were prospectively enrolled in the study. Refractory hypoxia was defined as oxygenation index (OI) \u2265 25 for at least 4\u2009hours after the commencement of high-frequency oscillatory ventilation and nitric oxide at 20\u2009ppm. Refractory hypotension was defined as mean blood pressure lesser than mean gestational age lasting for more than 15\u2009minutes in spite of dopamine infusion at 10 \u00b5g\/kg\/min, adrenaline infusion at 0.3 \u00b5g\/kg\/min, and noradrenaline infusion at 0.1 \u00b5g\/kg\/min.<\/jats:p>\n                  <jats:p>Results\u2003Thirty-two neonates with PPHN were recruited. The baseline OI (mean\u2009\u00b1\u2009standard deviation [SD]) before starting VP was 33.43\u2009\u00b1\u200916.54 which started decreasing significantly between 1 and 6\u2009hours after the commencement of VP (p\u2009&lt;\u20090.05). The mean blood pressure also increased concomitantly with a significant effect seen by 1\u2009hour (p\u2009&lt;\u20090.05). The vasoactive infusion score before the commencement of VP was mean 46.07 (SD\u2009=\u200925.72) and started decreasing after 12 to 24\u2009hours of commencement of VP (p\u2009&lt;\u20090.05). Lactate levels (mean\u2009\u00b1\u2009SD) before starting VP were 7.8\u2009\u00b1\u20098.6\u2009mmol\/L and started decreasing between 6 and 12\u2009hours (p\u2009&lt;\u20090.05). Two neonates died due to refractory hypoxia and refractory hypotension (overall mortality 6.2%)<\/jats:p>\n                  <jats:p>Conclusion\u2003Rescue VP therapy is a useful adjunct in the management of neonates with severe PPHN with refractory hypoxia and\/or refractory hypotension. Improvement in oxygenation and hemodynamics with the use of VP results in reduced mortality.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/a-1969-1119","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T20:41:53Z","timestamp":1666903313000},"page":"e886-e892","source":"Crossref","is-referenced-by-count":7,"special_numbering":"S","title":["Use of Vasopressin as Rescue Therapy in Refractory Hypoxia and Refractory Systemic Hypotension in Term Neonates with Severe Persistent Pulmonary Hypertension\u2014A Prospective Observational Study"],"prefix":"10.1055","volume":"41","author":[{"given":"Sachin","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Services, Surya Mother & Child Superspeciality Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleha","family":"Dhalait","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Services, Surya Mother & Child Superspeciality Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Fursule","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Services, Surya Mother & Child Superspeciality Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant","family":"Khandare","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Services, Surya Mother & Child Superspeciality Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-2038","authenticated-orcid":false,"given":"Amita","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Services, Surya Mother & Child Superspeciality Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref1","first-page":"136","article-title":"Persistent pulmonary hypertension of the newborn","volume":"27","author":"G Chetan","year":"2007","journal-title":"Biomedicine"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1080\/14767058.2018.1536740","article-title":"An Asian multicenter retrospective study on persistent pulmonary hypertension of the newborn: incidence, etiology, diagnosis, treatment and outcome","volume":"33","author":"N 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