Cardiopulmonary Bypass Clinical Trial
Official title:
Pilot Study of the Effects of Nesiritide on Hemodynamics and Urine Output Following Cardiopulmonary Bypass in Infants
The purpose of this study is to determine the effects of nesiritide on urine output and hemodynamics following cardiopulmonary bypass in infants. Safety and pharmacokinetic data will also be obtained.
Nesiritide, a recombinant human B-type natriuretic peptide, has vasodilatory, lusitropic and
diuretic properties in healthy humans, and improves hemodynamics and symptoms in adults with
decompensated congestive heart failure. Several retrospective case series suggest that
nesiritide has beneficial effects on hemodynamics and urine output in adults and children
following cardiac surgery.
The purpose of this prospective, randomized, double-blind, crossover study is to evaluate the
effects of a continuous infusion of nesiritide on postoperative hemodynamics and urine output
in infants with congenital heart disease who undergo cardiac surgery requiring
cardiopulmonary bypass (CPB). Patients less than 1 year of age following cardiac surgery will
be eligible for the study if they have received two conventional diuretics (furosemide and
chlorothiazide) for at least 12 hours, yet are not effectively achieving a negative fluid
balance, thus prohibiting sternal closure or tracheal extubation. Patients will be randomized
to receive either a 10-hour infusion of nesiritide, a two hour washout period, followed by a
10-hour infusion of placebo, or this study drug sequence in reverse order. During the 24-hour
study period, serial cardiac output measurements and BNP levels will be obtained, vital signs
and intracardiac filling pressures will be recorded, and urine output will be measured.
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