478 Haemodynamics Following Intravenous Paracetamol Administration in (PRE) Term Neonates

Abstract

Introduction: There are recent observations on the haemodynamics of intravenous paracetamol (hypotension) in adult IC setting (1). We therefore evaluated the haemodynamics following iv paracetamol loading dose (20 mg.kg^-1) in (pre)term neonates.

Methods: Pooled analysis of observations on heart rate and blood pressure (mean, systolic, diastolic) collected during iv paracetamol pharmacokinetic studies in neonates already reported (2,3) or collected during the ongoing PK/PD iv paracetamol study (PARANEO, NCT 00969176). Heart rate and blood pressure (arterial access) were recorded just before and 30, 60, 120, 180, 240, 300 and 360 minutes afterwards. Data by median, paired analysis (Wilcoxon).

Results: Data in 64 neonates (GA 35 weeks, PNA 2 days, weight 2.425 kg) were available. Heart rate decreased from (pre) 143 bpm to 137 (p< 0.01), 140 (p< 0.05), 137 (p< 0.01), 133 (p< 0.01), and 140 (p< 0.05) bpm at 30, 60, 120, 180, 240-360 min. Mean blood pressure decreased (pre = 46 mmHg) to 43 at 60 min, 300 and 360 minutes (p< 0.05), while there were no significant changes in systolic or diastolic blood pressure.

Conclusions: Statistical significant, clinical minor effects on heart rate (-6 to -8) and blood pressure (-3 mmHg) were documented following iv paracetamol. These changes may reflect improved analgesia, but it seems cautious to consider impaired haemodynamics to be a relative contra-indication for intravenous paracetamol.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD