Acute cardiopulmonary effects of pancuronium bromide in mechanically ventilated newborn infants

Beatriz Runkle, Eduardo Bancalari

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

The short-term effects of muscle relaxation with pancuronium bromide on arterial blood gas values, heart rate, and arterial blood pressure were studied in 49 neonates receiving mechanical ventilation. After pancuronium administration, mean PaO2 increased from 61.9±30.0 to 80.9±52.8 mm Hg (P=0.006), mean PaCO2 decreased from 40.1±13.0 to 37.5±13.3 mm Hg (P=0.03), and mean heart rate rose from 146.2±24.9 to 161.0±20.5 beats/min (P<0.001). Arterial blood pressure did not change significantly. When results were analyzed by diagnosis (meconium aspiration syndrome, hyaline membrane disease, pneumonia), only infants with meconium aspiration syndrome had a significant improvement in oxygenation (P=0.008). Six of 18 patients with hyaline membrane disease responded to muscle relaxation, with a decrease in PaO2 of 10mm Hg or more. No significant correlation was found between change in PaO2 and birth weight, gestational age, postnatal age, or change in heart rate. A weak correlation (r=-0.37, P<0.006) was observed between change in PaO2 and change in PaCO2. Although the reasons for the divergence in response in different groups of patients are not entirely clear, the risk of deterioration with pancuronium therapy should be kept in mind, particularly if treatment in an infant with hyaline membrane disease is being considered.

Original languageEnglish (US)
Pages (from-to)614-617
Number of pages4
JournalThe Journal of Pediatrics
Volume104
Issue number4
DOIs
StatePublished - Apr 1984
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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