IMPROVED OXYGENATION FOLLOWING ADENOSINE INFUSION IN PERSISTENT PULMONARY-HYPERTENSION OF THE NEWBORN

Six consecutive cases of persistent pulmonary hypertension of the newb orn (PPHN) were treated with adenosine following failure of convention al therapy, excluding inhaled nitric oxide. A rise in arterial P-O2 >2 0 mm Hg occurred in 5 of 6 cases within 30 min of commencing adenosine infusion. Individual maximal increases in PaO2 ranged from 31 to 131 mm Hg. Three neonates survived and 3 died. Amongst deaths, intensive s upport was withdrawn in a preterm neonate due to severe arthrogryposis /pulmonary hypoplasia. Of the remaining 2, the improvement in oxygenat ion persisted until death occurred from causes unrelated to adenosine. Side effects related to adenosine (bradycardia, hypotension, prolonge d bleeding time) did not occur. Due to its ease of availability, admin istration and extremely short half-life, adenosine may be an important therapeutic option in PPHN.