Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants
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Monika Herbst Gantenbein
Abstract
Aim: To analyze the side effects of captopril, an angiotensin converting enzyme inhibitor (ACEI) in newborn and young infants.
Methods: Retrospective analysis of side effects in 43 patients with congenital heart disease after cardiac surgery treated with captopril for heart failure during a two-year period.
Results: Median age of the patients was 26 days (range 6–310 days), median weight 3.5 kg (range 1.9–7.9 kg). Initial median dose of captopril was 0.17 mg/kg/day (range 0.05–0.55 mg/kg/day), slowly increased over 3–33 days to a maximal median dose of 1.86 mg/kg/day (range 0.2–2.3 mg/kg/day). All patients were additionally treated with diuretics. Side effects occurred in 17 patients (renal impairment or failure in 6, low blood pressure in 8, and oxygen saturation deficit in 3) requiring cessation or interruption in seven patients with renal impairment/failure (n=4), hypotension (n=1) and aorto-pulmonary shunting with low pulmonary perfusion (n=2). The six children who developed renal impairment or failure did so following a median delay of nine days after reaching the final dose and weighed on average 500 g less than the other patients (P=0.046). All side effects were fully reversible.
Conclusion: Side effects due to captopril were not dose-related in newborns and infants in this study. However, renal side effects occurred more often in smaller infants. Routine monitoring of infants on ACEI should include renal function tests, blood pressure and transcutaneous oxygen saturation measurements.
©2008 by Walter de Gruyter Berlin New York
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- Original articles – Obstetrics
- Premature labor: a state of platelet activation?
- Soluble receptor for advanced glycation end products (sRAGE) and endogenous secretory RAGE (esRAGE) in amniotic fluid: modulation by infection and inflammation
- Detection of feto-maternal infection/inflammation by the soluble receptor for advanced glycation end products (sRAGE): results of a pilot study
- Weight gain in pregnancy according to maternal height and weight
- A randomized trial of tight vs. less tight control of mild essential and gestational hypertension in pregnancy
- Pregnancy outcome of women who developed proteinuria in the absence of hypertension after mid-gestation
- Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology
- Original article – Fetus
- Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation
- Original articles – Newborn
- Bronchopulmonary dysplasia and early prophylactic inhaled nitric oxide in preterm infants: current concepts and future research strategies in animal models
- Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants
- Letters to the editor
- Mirror syndrome due to coxackie B virus associated to maternal peripartum cardiomyopathy
- Non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Commentary: A case of non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Congress Calendar
- 10.1515/JPM.2008.095
- Erratum
- Total body water in small- and appropriate - for gestational age newborns
- Announcement
- Calling European Pediatric Research Networks
- WAPM-Newsletter
- WAPM-Newsletter No 1/2008
