No abstract

Eleven newborns admitted consecutively to the neonatal unit with respiratory failure and severe persistent pulmonary hypertension (PPHN) were included in a clinical trial to assess the efficacy of magnesium sulphate (MgSO4) in the treatment of PPHN. A loading dose of 200 mg/kg MgSO4 was given over 20 minutes, followed by a continuous infusion of 20-150 mg/kg/hour to obtain a magnesium blood concentration between 3 5 and 5 5 mmol/l. Mean (SD) duration of treatment was 75-5 (19.8) hours. No other vasodilatory drug was administered before or during the treatment and patients were not hyperventilated. Mean (SEM) PaO2 values significantly increased from 42-6 (8.8) before treatment to 70*3 (24.1) mm Hg after 24 hours, with no change in pH or Pco2. Oxygen index and alveolar-arterial oxygen gradient (A-aDo2) were significantly lower after 24 hours; respectively, 46-8 (15.2) to 28-0 (9.0) and 624-3 (11-3) to 590 (58) nmn Hg. Mean airway pressure could be significantly reduced from 19*5 (3-1) to 13-9

The long-term results of our retrospective study confirm that surgery has to be considered the gold standard for the treatment of aortic coarctation. The interventional angioplasty techniques have to provide long-term outcome at least similar to the results obtained with surgery.

No abstract

Despite late referral, and initially inadequate left ventricular volume and mural thickness, children with transposition can successfully be treated with the arterial switch procedure, provided that the left ventricle is adequately prepared, using echocardiography to monitor left ventricular morphology and function.