Administration of a large nesiritide bolus dose in a pediatric patient

Case report and review of nesiritide use in pediatrics

Brady S. Moffett, John Jefferies, Jack F. Price, Sarah Clunie, Susan Denfield, William J. Dreyer, Jeffrey Towbin

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Nesiritide (recombinant B-type natriuretic peptide) is often given for symptomatic relief of acute decompensated heart failure in adults. The literature describing the safety or efficacy of nesiritide in children is minimal, and we know of no data that describe the effects of a nesiritide overdose in adults or children. A 3-year-old, 10.9-kg girl was admitted to the pediatric intensive care unit with the diagnosis of dilated cardiomyopathy and acute decompensated heart failure. She received several vasoactive infusions during her admission, including nesiritide. On hospital day 47 (day 45 of nesiritide therapy), the patient received an 18-fold overdose of nesiritide, with no hemodynamic, cardiac, or renal sequelae. She subsequently underwent successful cardiac transplantation. The nesiritide treatment duration was longer for this patient than the 45 days previously reported in a pediatric patient. No hemodynamic instability or cardiac or renal sequelae were associated with the large, inadvertent bolus in our patient. This case report demonstrates the lack of adverse events in a pediatric patient administered nesiritide beyond the recommended dosing parameters. Increased vigilance is always advised when administering drugs not commonly given to pediatric patients.

Original languageEnglish (US)
Pages (from-to)277-280
Number of pages4
JournalPharmacotherapy
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

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Brain Natriuretic Peptide
Pediatrics
Heart Failure
Hemodynamics
Kidney
Pediatric Intensive Care Units
Dilated Cardiomyopathy
Heart Transplantation
Safety
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Administration of a large nesiritide bolus dose in a pediatric patient : Case report and review of nesiritide use in pediatrics. / Moffett, Brady S.; Jefferies, John; Price, Jack F.; Clunie, Sarah; Denfield, Susan; Dreyer, William J.; Towbin, Jeffrey.

In: Pharmacotherapy, Vol. 26, No. 2, 01.02.2006, p. 277-280.

Research output: Contribution to journalReview article

Moffett, Brady S. ; Jefferies, John ; Price, Jack F. ; Clunie, Sarah ; Denfield, Susan ; Dreyer, William J. ; Towbin, Jeffrey. / Administration of a large nesiritide bolus dose in a pediatric patient : Case report and review of nesiritide use in pediatrics. In: Pharmacotherapy. 2006 ; Vol. 26, No. 2. pp. 277-280.
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