Effect of tolazoline on persistent hypoxemia in severe hyaline membrane disease

• Published in: Yonsei medical journal Vol. 31; no. 2; pp. 156 - 162
• Main Authors: Park, K I, Namgung, R, Lee, C, Han, D G
• Format: Journal Article
• Language: English
• Published: Korea (South) 01.06.1990
• Subjects: Humans; Hyaline Membrane Disease - complications; Hypoxia - drug therapy; Infant; Infant, Newborn; Infusions, Intravenous; Tolazoline - administration & dosage; Tolazoline - therapeutic use
• ISSN: 0513-5796
• DOI: 10.3349/ymj.1990.31.2.156

Ten critically-ill preterm infants with severe hyaline membrane disease received tolazoline because of persistent hypoxemia refractory to the administration of 100% oxygen and mechanical ventilation. Seven infants (70%) responded immediately with an increase in PaO2 greater than or equal to 20 mmHg in the umbilical arterial gas within 60 minutes after bolus infusion (1 to 2 mg/kg) of tolazoline. Twenty-four hours later after the tolazoline infusion, the FiO2 had been decreased from 1.0 to a mean of 0.82 +/- 0.16, and the MAP from 16.5 +/- 1.8 to 15.6 +/- 4.5 cm H2O. Four of 7 infants (57%) who had an immediate response survived, whereas none survived out of 3 infants who failed to respond initially. Three infants experienced relatively severe complications possibly related to tolazoline. There appears to be a place for the use of tolazoline in a severely hypoxemic infant with hyaline membrane disease who is being ventilated, and in whom arterial oxygenation cannot be improved by a further increase in the inspired oxygen concentration or by an alteration of ventilator settings.