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September 1, 2005Pediatric Critical Care Medicine

Nesiritide in infants and children with congestive heart failure*

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Why the study?

Does nesiritide improve fluid balance in infants and children with congestive heart failure?

Population

30 infants and children with primary heart failure or low cardiac output after heart surgery, already…

Design

Case_series, open-label

Follow-up

24 hours (for primary outcome assessment)

Authors

WMWilliam T. MahlePediatric CardiologyACAngel R. CuadradoEmory UniversityPKPaul M. KirshbomBon Secours Heart & Vascular Institute

Discussion

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Implication

Should not yet change practice in pediatric HF; hypothesis-generating for nesiritide in fluid management.

Structured PICO

Does nesiritide improve fluid balance in infants and children with congestive heart failure?

P
Population
30 infants and children (aged 5 days to 16.7 years, median age 4.6 months) with primary heart failure or low cardiac output after heart surgery (including single-ventricle congenital defect, two-ventricle congenital defect, heart transplant, and dilated cardiomyopathy), already receiving inotropic and diuretic therapy.
I
Intervention
Nesiritide (synthetic B-type natriuretic peptide) administered as a continuous infusion (0.005 to 0.02 microg/kg/min), mostly with an initial bolus, added to inotropic and diuretic therapy for a median of 4 days (range 1 to 24 days).
O
Outcome
Change in fluid balance and right atrial pressure after 24 hours of therapy.surrogate

Nesiritide appears well tolerated and is associated with improved diuresis in pediatric patients with heart failure, suggesting potential utility in this population.

Cite This Study

Mahle et al. (2005) studied this question.

synapsesocial.com/papers/6a87c3a6e9ff8443d248eef0https://doi.org/10.1097/01.pcc.0000164634.58297.9a

Topics

Heart failureHFrEF treatment
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Preliminary Experience With Nesiritide in the Pediatric Population2004 · 33 citations
  2. 2Nesiritide Does Not Improve Renal Function in Patients With Chronic Heart Failure and Worsening Serum Creatinine2004 · 194 citations
  3. 3Effect of nesiritide versus milrinone in the treatment of acute decompensated heart failure2003 · 22 citations
  4. 4Hemodynamic and Renal Excretory Effects of Human Brain Natriuretic Peptide Infusion in Patients With Congestive Heart Failure1996 · 302 citations
  5. 5Efficacy and Safety of Milrinone in Preventing Low Cardiac Output Syndrome in Infants and Children After Corrective Surgery for Congenital Heart Disease2003 · 775 citations