Vasopressin and Hemodynamic Effects on the Neonate

Abstract

Hemodynamic disturbances are prevalent in the neonatal population; however, despite this, no consensus exists regarding treatment algorithms for the most common conditions. Vasopressin is frequently used in adults and older children, but its use in neonates has been limited. This is primarily because of concerns about ischemic events including necrotizing enterocolitis as well as a paucity of evidence and experience in this population. More literature in neonates has become available in the last few years but currently only includes case reports, reviews, and small prospective studies on vasopressin use for treating hypotension, pulmonary hypertension, and after cardiac surgery. These reports suggest benefit with vasopressin for these indications; however, publication bias and small sample sizes limit the ability to definitively apply the results into practice. Large multicenter randomized trials are needed to validate findings and to assist neonatologists in determining the ideal treatment algorithms for various hemodynamic disorders of the neonate.