Norepinephrine, enoximone, and nitric oxide for treatment of myocardial stunning and pulmonary hypertension in a newborn with diaphragmatic hernia

J Pediatr Surg. 1995 Jun;30(6):801-4. doi: 10.1016/0022-3468(95)90751-3.

Abstract

A newborn with right diaphragmatic hernia suffered myocardial stunning and suprasystemic pulmonary hypertension secondary to postpartal asphyxia. In addition to conventional therapy, norepinephrine, enoximone, and inhalational nitric oxide were successfully used. Norepinephrine improved myocardial perfusion pressure; the addition of enoximone, a phosphodiesterase-inhibitor, to beta-adrenergic agents increased cardiac performance. with decreasing concentrations of inhalational nitric oxide, severe pulmonary hypertension resolved after a few days, suggesting that transient endothelial dysfunction was partially responsible for pulmonary vasoconstriction in the newborn with congenital diaphragmatic hernia.

Publication types

  • Case Reports

MeSH terms

  • Enoximone / therapeutic use*
  • Hernia, Diaphragmatic / complications*
  • Hernia, Diaphragmatic / physiopathology
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / physiopathology
  • Infant, Newborn
  • Male
  • Myocardial Stunning / drug therapy*
  • Myocardial Stunning / etiology
  • Myocardial Stunning / physiopathology
  • Nitric Oxide / therapeutic use*
  • Norepinephrine / therapeutic use*
  • Treatment Outcome

Substances

  • Nitric Oxide
  • Enoximone
  • Norepinephrine