Inhaled Epoprostenol for Pulmonary Hypertension Treatment in Neonates: A 12-Year Experience.
Am J Perinatol
; 36(11): 1142-1149, 2019 09.
Article
de En
| MEDLINE
| ID: mdl-30551229
ABSTRACT
BACKGROUND:
Persistent pulmonary hypertension of the newborn (PPHN) occurs in 10% of neonatal respiratory insufficiency. To selectively reduce pulmonary vascular resistance, several treatments have been tried. Inhaled epoprostenol (iPGI2) has been used for 12 years in our institution for the management of refractory PPHN despite the gaps in the literature to support this use.OBJECTIVES:
The primary objective was to evaluate the efficacy of iPGI2 for PPHN. The secondary objectives were to describe its use in neonates and assess side effects. STUDYDESIGN:
This retrospective cohort study included infants < 28 days with PPHN treated with iPGI2 in the neonatal or pediatric intensive care units of our institution between 2004 and 2016.RESULTS:
We reviewed 43 patient' care episodes (mean gestational age of 36 weeks). This was an extremely ill population with 54% mortality rate. Oxygenation index improved significantly after 12-hour treatment (p = 0.047), with a rebound effect when discontinuing nebulization. By the end of the therapy, the fraction of inspired oxygen had significantly dropped (p = 0.0018). Echocardiographic markers tended to normalize during treatment. No potential side effects were reported.CONCLUSION:
In these sick newborns, we observed an improvement in PPHN under iPGI2 without significant adverse effects. To our knowledge, this is the largest neonatal cohort reported to have received iPGI2 for PPHN.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Persistance de la circulation foetale
/
Prostacycline
/
Maladies du prématuré
/
Antihypertenseurs
Type d'étude:
Observational_studies
Limites:
Female
/
Humans
/
Male
/
Newborn
Langue:
En
Journal:
Am J Perinatol
Année:
2019
Type de document:
Article
Pays d'affiliation:
Canada