Human atrial natriuretic peptide infusion for a neonate with congestive heart failure after total correction of total anomalous pulmonary venous connection

A successful case of human atrial natriuretic peptide (HANP) infusion thera py for a neonate who developed congestive heart failure (CHF) after total r epair of total anomalous pulmonary venous connection was performed on the f irst day of life. Following 14 h of HANP infusion at incremental doses of 0 .125-0.25 mu g.kg(-1).min(-1), urine output and hemodynamics dramatically i mproved. Urine output increased from 1.1 to 10.6 ml/h (p<0.0001) and good u rinary output (13.0 ml/h) was maintained even after discontinuation of the infusion. During the infusion, the heart rate decreased from 166 to 152 bea ts/min (p<0.0001), and the systemic systolic blood pressure increased from 82 to 103 mmHg (p<0.0001), Central venous pressure was not significantly af fected by HANP infusion. This is the first successful case of HANP infusion therapy as the first treatment of post-operative pulmonary hypertension in this age group. This therapy can be used safely and may be useful in neona tes with CHF resulting from other causes, but more investigation is needed.