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Lack of efficacy: case report A male neonate [exact age not stated] exhibited lack of efficacy while being treatment with digoxin and sildenafil for congestive heart failure (CHF). The neonate developed CHF immediately after caesarean section delivery at 40 weeks of gestation. He was prenatally diagnosed with the vein of Galen aneurysmal malformation (VGAM) at 31 weeks of gestation. For CHF, he was commenced on fentanyl, furosemide and milrinone. Subsequently, he was embolised and received an injection of ethylene vinyl alcohol copolymer [Onyx] to the complete obliteration. A reduction of bruit was achieved. Thereafter, he developed tachycardia, which was treated with esmolol. Additionally, he developed pneumonia, which was treated with oxacillin along with amikacin. However, his cardiopulmonary function continued to worsen. Thereafter, he received digoxin and sildenafil [routes and dosages not stated]. However, he failed to respond this treatment (lack of efficacy). Eventually, he died due to CHF on 20 day of life. Demartini Z, et al. Prenatal Diagnosis of Vein of Galen Aneurysmal Malformation Allows Early Transumbilical Endovascular Treatment. Brazilian Neurosurgery 39: 213-216, 803519685 No. 3, Sep 2020. Available from: URL: http://doi.org/10.1055/s-0040-1710311

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Reactions 5 Dec 2020 No. 1833