Sodium nitroprusside, a lifesaving treatment for neonatal hypertension: an Irish experience.

Abstract

We present a 30+2-weeks-old (30 weeks and 2 days) male, twin 1, born by emergency caesarean section due to twin-twin transfusion syndrome (absent end-diastolic flow and cardiac anomaly in twin 2) presenting with hypertensive crisis on day 3. He was already on milrinone and propranolol. His echocardiogram showed poor left ventricular contractility and after cardiology consultation received sodium nitroprusside, which eventually saved his life by decreasing his blood pressure and improving cardiac function. As sodium nitroprusside is very rarely used for hypertensive crisis in neonates, we would like to share our experiences on dosage, challenges in administration due to its fast onset of action, criteria for monitoring for complications and finally weaning. Baby developed severe bilateral periventricular leukomalacia as a potential complication of hypertensive crisis, preceded by bilateral periventricular flare secondary to twin-twin transfusion.

• Authors: Alina Gina Deliu, Phani Bhushan Jeerigehalli Sanneerappa, Orla Franklin, Johannes Letshwiti
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2018 (Mar 28 2018) ISSN: 1757-790X [Electronic] England
• PMID: 29592974 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Chemical References

• Antihypertensive Agents
• Nitroprusside

Topics

• Antihypertensive Agents (therapeutic use)
• Diagnosis, Differential
• Female
• Fetofetal Transfusion (complications)
• Humans
• Hypertension (complications, drug therapy)
• Infant
• Ireland
• Male
• Nitroprusside (therapeutic use)
• Pregnancy
• Treatment Outcome