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Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review

Introduction: The use of arginine vasopressin (AVP) and terlipressin to treat hypotension in preterm neonates is increasing. Our aim was to review the available evidence on the efficacy and safety of AVP and terlipressin for use in preterm neonates. Methods: MEDLINE, EMBASE, the Cochrane Central Reg...

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Autores principales: Al-Saadi, Abdulrahman, Sushko, Katelyn, Bui, Vivian, van den Anker, John, Razak, Abdul, Samiee-Zafarghandy, Samira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658127/
https://www.ncbi.nlm.nih.gov/pubmed/36360641
http://dx.doi.org/10.3390/ijerph192113760
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author Al-Saadi, Abdulrahman
Sushko, Katelyn
Bui, Vivian
van den Anker, John
Razak, Abdul
Samiee-Zafarghandy, Samira
author_facet Al-Saadi, Abdulrahman
Sushko, Katelyn
Bui, Vivian
van den Anker, John
Razak, Abdul
Samiee-Zafarghandy, Samira
author_sort Al-Saadi, Abdulrahman
collection PubMed
description Introduction: The use of arginine vasopressin (AVP) and terlipressin to treat hypotension in preterm neonates is increasing. Our aim was to review the available evidence on the efficacy and safety of AVP and terlipressin for use in preterm neonates. Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar from inception to September 2021 were searched for studies of AVP and terlipressin in the treatment of hypotension of any cause in preterm neonates. Primary outcomes were improvement in end-organ perfusion and mortality. The risk of bias assessment and certainty of the evidence were performed using appropriate tools. Results: Fifteen studies describing the use of AVP (n = 12) or terlipressin (n = 3) among 148 preterm neonates were included. Certainly, the available evidence for the primary outcome of end-organ perfusion rated as very low. AVP or terlipressin were used to treat 144 and 4 neonates, respectively. Improvement in markers of end-organ perfusion was reported in 143 (99%) neonates treated with AVP and 3 (75%) treated with terlipressin. The mortality rate was 41% (n = 59) and 50% (n = 2) for neonates who received AVP and terlipressin, respectively. Hyponatremia was the most frequently reported adverse event (n = 37, 25%). Conclusion: AVP and terlipressin may improve measured blood pressure values and possibly end-organ perfusion among neonates with refractory hypotension. However, the efficacy–safety balance of these drugs should be assessed on an individual basis and as per the underlying cause. Studies on the optimal dosing, efficacy, and safety of AVP and terlipressin in preterm neonates with variable underlying conditions are critically needed.
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spelling pubmed-96581272022-11-15 Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review Al-Saadi, Abdulrahman Sushko, Katelyn Bui, Vivian van den Anker, John Razak, Abdul Samiee-Zafarghandy, Samira Int J Environ Res Public Health Systematic Review Introduction: The use of arginine vasopressin (AVP) and terlipressin to treat hypotension in preterm neonates is increasing. Our aim was to review the available evidence on the efficacy and safety of AVP and terlipressin for use in preterm neonates. Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar from inception to September 2021 were searched for studies of AVP and terlipressin in the treatment of hypotension of any cause in preterm neonates. Primary outcomes were improvement in end-organ perfusion and mortality. The risk of bias assessment and certainty of the evidence were performed using appropriate tools. Results: Fifteen studies describing the use of AVP (n = 12) or terlipressin (n = 3) among 148 preterm neonates were included. Certainly, the available evidence for the primary outcome of end-organ perfusion rated as very low. AVP or terlipressin were used to treat 144 and 4 neonates, respectively. Improvement in markers of end-organ perfusion was reported in 143 (99%) neonates treated with AVP and 3 (75%) treated with terlipressin. The mortality rate was 41% (n = 59) and 50% (n = 2) for neonates who received AVP and terlipressin, respectively. Hyponatremia was the most frequently reported adverse event (n = 37, 25%). Conclusion: AVP and terlipressin may improve measured blood pressure values and possibly end-organ perfusion among neonates with refractory hypotension. However, the efficacy–safety balance of these drugs should be assessed on an individual basis and as per the underlying cause. Studies on the optimal dosing, efficacy, and safety of AVP and terlipressin in preterm neonates with variable underlying conditions are critically needed. MDPI 2022-10-22 /pmc/articles/PMC9658127/ /pubmed/36360641 http://dx.doi.org/10.3390/ijerph192113760 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Al-Saadi, Abdulrahman
Sushko, Katelyn
Bui, Vivian
van den Anker, John
Razak, Abdul
Samiee-Zafarghandy, Samira
Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title_full Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title_fullStr Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title_full_unstemmed Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title_short Efficacy and Safety of Vasopressin and Terlipressin in Preterm Neonates: A Systematic Review
title_sort efficacy and safety of vasopressin and terlipressin in preterm neonates: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658127/
https://www.ncbi.nlm.nih.gov/pubmed/36360641
http://dx.doi.org/10.3390/ijerph192113760
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