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Table 1 Patient characteristics and clinical details

From: Arginine-vasopressin in catecholamine-refractory septic versus non-septic shock in extremely low birth weight infants with acute renal injury

Patient Age (gender)/birth weight/APGAR score Underlying disease/treatment Cause/time of onset of shock Urine output/Increase in serum creatinine/Serum lactate prior to AVP Echocardiography Dosage/duration of AVP NE/E prior to AVP Further NE/E Clinical outcome/complications
1 24 + 6 wks (F); caesarean delivery; 600 g APGAR: 7/9/9 RDS, PDA Mechanical ventilation Surgical closure of PDA Klebsiella pneumoniae sepsis 10th day of life 0.2 ml/kg/h 2.3 times 8.5 mmol/l SF: 34–38% After an initial bolus of 0.025 U, 0.035 U/kg/h 36 hours NE: 0.5 μg/kg/minute E: 0.5 μg/kg/minute Continuation of NE/E over 28 hours after cessation of AVP therapy in decreasing dosage Survived; BPD; ROP II; Two cystic lesions (occipital and periventricular; 3–4 mm in diameter) most probably residues from intracranial hemorrhage
2 26 + 5 wks (F); caesarean delivery; 660 g APGAR: 3/7/8 RDS, PDA Mechanical ventilation Surgical closure of PDA Candida parapsilosis sepsis 12th day of life 0.1 ml/kg/h 2.1 times 14.4 mmol/ SF: 33–36% 0.10 U/kg/h 118 hours NE: 0.5 μg/kg/minute E: 0.5 μg/kg/minute Continuation of NE/E over 20 h after cessation of AVP therapy in decreasing dosage Survived; BPD; bilateral intraventricular hemorrhage without developing hydrocephalus; ROP I; no ischemic lesions secondary to AVP therapy
3 27 + 6 wks (M); caesarean delivery; 550 g APGAR: 6/7/7 RDS, prior acute renal injury possibly related to indomethacin administration Mechanical ventilation E. coli/Staph. epidermidis sepsis 5th week of life 0.2 ml/kg/h 1.5 times 5.2 mmol/l SF: 35–36% Initially 0.12 U/kg/h, increased to 0.36/U/kg/h 85 hours NE: 0.5–1.0 μg/kg/h E: 0.5–1.0 μg/kg/h Continuation of NE/E over the next 6 days after cessation of AVP therapy in increasing dosages Recurrent episode of acute renal injury; died; autopsy showed severe RDS; no ischemic lesions secondary to AVP therapy
4 Twin I: 26 + 1 wks (M); spontaneous vaginal delivery; 890 g APGAR: 4/7/8 RDS Progressive left ventricular dilatation Hyperkalemia Pneumothorax HFOV Drainage of pneumothoraces Intravenous calcium, β2-mimetics, insulin Low-cardiac output failure 3rd day of life 0.2 ml/kg/h 2.0 times 14.9 mmol/l SF: 15–20% 1st to 2nd degree mitral valve insufficiency PDA ruled out Initially 0.01 U/kg/h, increased to 0.1 U/kg/h 21 hours NE: 1.5 μg/kg/minute E: 1.5 μg/kg/minute Despite AVP increased demand for catecholamines (NE/E: 3 μg/kg/minute) Died after 21 hours of AVP therapy of cardio-respiratory failure; no ischemic lesions secondary to AVP therapy. A congenital cardiac malformation and cardiomyopathy were ruled out by autopsy
5 Twin II: 26+1 wks (M); spontaneous vaginal delivery; 880 g APGAR: 6/7/7 PIE Progressive left ventricular dilatation Hyperkalemia HFOV Intravenous calcium, β2-mimetics, insulin Low-cardiac output failure 3rd day of life 0.4 ml/kg/h 2.2 times 20.0 mmol/l SF: 15–20% 1st to 2nd degree mitral valve insufficiency PDA ruled out Initially 0.01 U/kg/h, increased to 0.03 U/kg/h 8 hours NE: 3.0 μg/kg/minute E: 3.0 μg/kg/minute Enoximone: 5 μg/kg/minute Despite AVP increased demand for catecholamines (NE/E: 5 μg/kg/minute) Died after 8 hours of AVP therapy of cardio-respiratory failure; no ischemic lesions secondary to AVP therapy. A congenital cardiac malformation and cardiomyopathy were ruled out by autopsy
6 Twin I: 24 + 5 wks (F); caesarean delivery; 550 g APGAR: 1/5/7 RDS Bilateral pneumothoraces Second degree intracranial hemorrhage Mechanical ventilation Drainage of pneumothoraces Non-septic circulatory collapse secondary to primary disease 6th day of life 0.3 ml/kg/h 2.7 times 10.9 mmol/l SF: 32–34% Initially 0.12 U/kg/h, increased to 0.36 U/kg/h 61 hours NE: 0.4 μg/kg/minute E: 0.4 μg/kg/minute Despite AVP catecholamines (NE/E: 0.6–0.8 μg/kg/minute) Died after 61 hours of AVP medication; liver tissue necrosis seen on autopsy as a possible sequelae of AVP medication
  1. AVP, arginine-vasopressin; BPD: Bronchopulmonary dysplasia; E, epinephrine; F, female; HFOV, high frequency oscillatory ventilation; M, male; NE, norepinephrine; PDA, persistant ductus arteriosus; PIE, pulmonary interstitial emphysema; RDS, respiratory distress syndrome; ROP, retinopathy of prematurity; SF, shortening fraction.