Vasopressin treatment a boon for new borns with severe pulmonary hypertension

Hyderabad: Persistent Pulmonary Hypertension (PPHN) is a rare and life-threatening condition that occurs in approximately 1 in 500 new borns. It is characterised by low oxygen levels and high pressure in the pulmonary arteries due to the blood vessels in the lungs failing to dilate after birth. Vasopressin, a hormone that can increase blood pressure by constricting blood vessels, is used as a rescue therapy when other interventions have failed to improve oxygenation and blood pressure in neonates with severe PPHN.

According to a prospective observational study on the use of vasopressin as a rescue therapy in term neonates (new borns) with severe PPHN, who have refractory hypoxia and refractory systemic hypotension, has shown promising results with 29 out of 31 enrolled neonates responding favourably to the treatment.

The study enrolled 31-term neonates with severe PPHN who were experiencing refractory hypoxia and refractory systemic hypotension despite standard treatments. The treating physicians determined the use of vasopressin as rescue therapy based on clinical judgement and standard practices. Out of the enrolled group of neonates, 29 responded favourably.

The researchers collected data on a variety of variables before and after the administration of vasopressin and recorded any adverse events associated with its use.

This prospective observational study has been carried out by the team of doctors at Surya Mother and Child Super Speciality Hospital, Pune.

The findings of the study may help inform clinical practice and guide future research in the use of vasopressin as rescue therapy in term neonates with severe PPHN. However, due to the nature of observational studies, the results may be subject to confounding factors, such as differences in the severity of illness or the underlying cause of PPHN between the neonates in the study.

A randomised controlled trial would be needed to establish a causal relationship between vasopressin and improved outcomes in this population.

Dr Sachin Shah, Director – Neonatal and Paediatric Intensive Care Services, Surya Hospitals Pune, said, "We are proud to have conducted this study and to have achieved such promising results. Vasopressin is an effective solution used to treat PPHN when unresponsive to other forms of treatment. We believe our findings may help inform clinical practice and guide future research in the use of vasopressin as rescue therapy in term neonates with severe PPHN. We look forward to continuing our research and making further contributions to the field of neonatology."

The study’s strength is its prospective design and pragmatic approach to relatively uncommon but life-threatening problems where clinicians are required to do “out of the box” thinking in a resource-limited setting.