Experimental and clinical effects of magnesium infusion in the treatment of neonatal pulmonary hypertension.

摘要: The appropriate treatment of persistent pulmonary hypertension the newborn has led to search for a specific vasodilator. Persistent is characterized by high vascular resistance resulting in right left shunting across fetal channels. ratio systemic determines magnitude this shunt, and agents which lower both blood pressure do not alleviate intracardiac shunt. Numerous vasodilator agents,including tolazoline, prostaglandins nitrovasodilators, have been used but all associated with problematic falls pressure. Magnesium, called nature's calcium blocker, antagonizes ion entry into smooth muscle cells, thus promoting vasodilatation. Magnesium also non-specific vasodilator,and while potentially lowering resistance, shown cause fall neonatal models hypoxic or septic hypertension. Case reports series cases noted beneficial effects human newborns, may due other magnesium (eg, sedation, relaxation, bronchodilatation cardioprotection). There are, however, no reported prospective randomized controlled trials sulphate newborns More recently, discovery that inhaled nitric oxide acts as without side reduce enthusiasm use infusions neonates appears be sufficient evidence at present justify trial evaluate role infusion newborns.