• Pediatr Int · Oct 2015

    Case Reports

    Effects of tolvaptan on congestive heart failure complicated with chylothorax in a neonate.

    • Nikiko Sato, Tokio Sugiura, Rika Nagasaki, Kazutaka Suzuki, Koichi Ito, Takenori Kato, Sachiko Inukai, and Shinji Saitoh.
    • Department of Pediatrics and Neonatology, Graduate School of Medical Sciences Nagoya City University, Nagoya, Japan.
    • Pediatr Int. 2015 Oct 1; 57 (5): 1020-2.

    AbstractTolvaptan is an oral vasopressin type 2 receptor antagonist that can be used for heart failure patients with hyponatremia or symptomatic congestion. Although the effects of tolvaptan in adults have been well documented, only limited information is available in children. The case of a neonate with congestive heart failure complicated with chylothorax after palliative surgery for transposition of the great arteries treated with tolvaptan is reported. Slow up-titration to 0.1 mg/kg successfully increased urine output and improved refractory congestive heart failure without hypernatremia. Subsequently, bodyweight and chylothorax decreased gradually. Moreover, the use of tolvaptan reduced the dosage of furosemide. Tolvaptan could be an alternative drug for neonates with congestive heart failure. Further large studies are needed to confirm the efficacy and identify the appropriate dose of tolvaptan in neonates.© 2015 Japan Pediatric Society.

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