Mavinkurve Meenal, McGrath Niamh, Johnston Niall, Moloney Sinead, Murphy Nuala P, Hawkes Colin P
Department of Endocrinology, The Children's University Hospital, Temple Street, Dublin, Ireland.
School of Medicine, University College Dublin, Dublin, Ireland.
J Pediatr Endocrinol Metab. 2017 May 24;30(6):623-628. doi: 10.1515/jpem-2017-0051.
Neonatal central diabetes insipidus (NCDI) remains a therapeutic challenge, as extremely low doses of enteral desmopressin cannot be titrated with current preparations. The aim of this study was to describe the use of orally administered dilute desmopressin in NCDI.
Nasal desmopressin (100 μg/mL) was diluted in 0.9% saline to 10 μg/mL. Infants were treated with 1-5 μg and doses were titrated to a twice-daily regimen. The feed volume was 150 mL/kg/day and titrated according to weight gain.
Five infants aged 6-105 days were included. Stabilizing treatment doses ranged from 2 to 5 μg twice daily in neonates, and 12 μg twice daily in the older infant who was diagnosed at 105 days.
Dilution of nasal desmopressin with saline facilitates safe administration and dose titration in NCDI. We recommend considering this therapeutic approach to NCDI, particularly in small infants or where alternative treatment regimens have been unsuccessful.
新生儿中枢性尿崩症（NCDI）仍然是一个治疗挑战，因为目前的制剂无法滴定极低剂量的肠内去氨加压素。本研究的目的是描述口服稀释去氨加压素在NCDI中的应用。
将鼻用去氨加压素（100μg/mL）用0.9%生理盐水稀释至10μg/mL。婴儿接受1-5μg治疗，剂量滴定至每日两次给药方案。喂养量为150mL/kg/天，并根据体重增加情况进行滴定。
纳入了5名年龄在6-105天的婴儿。新生儿稳定治疗剂量为每日两次2-5μg，105天诊断的较大婴儿为每日两次12μg。
用生理盐水稀释鼻用去氨加压素便于在NCDI中安全给药和剂量滴定。我们建议考虑这种治疗NCDI的方法，特别是在小婴儿或替代治疗方案不成功的情况下。
