The acute effects of nicardipine in postoperative paediatric cardiac surgical patients under 12 months of age: A descriptive study utilising high-fidelity physiologic streaming data

Affiliations

Advocate Children's Hospital, Oak Lawn

Abstract

Background: Utilisation of nicardipine in the neonatal and infant period has been historically avoided due to a concern for a more calcium-sensitive myocardium. The aim of this study was to characterise the association between nicardipine and systolic blood pressure in neonates and infants after cardiac surgery.

Methods: In this single-centre, retrospective study, patients under 12 months of age who underwent cardiac surgery and received nicardipine for at least one hour were included (September 2022 to January 2024). Patients were monitored with Etiometry. Variables of interest included haemodynamic parameters, ionised calcium, serum lactate, vasoactive infusion score, and nicardipine dose. A time series regression was conducted with each patient having 5 distinct time points.

Results: One hundred and eighty-five time points were collected across 37 patients with a mean age of 3 months. Of these patients, 22% were neonates and 32% were functionally univentricular. With nicardipine utilisation, a decrease in systolic blood pressure of 14 mmHg after an 8-hour time period was noted (p = 0.017). Heart rate, diastolic blood pressure, cerebral and renal oxygen extraction, ionised calcium, serum lactate, and vasoactive inotrope score did not significantly change over the study period.

Conclusion: Nicardipine utilisation in neonates and infants after cardiac surgery was associated with decreased systolic blood pressure. Indirect markers demonstrate no change in cardiac function. Additional studies are needed to better elucidate nicardipine's role in this patient population.

Type

Article

PubMed ID

41572641

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