Anesthetic management of children with pulmonary arterial hypertension

Galante, Dario; Meola, Salvatore; Pellico, Giuseppe; Tancredi, Maria Luciana; Milillo, Rosella

doi:10.1111/j.1460-9592.2008.02536.x

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…The use of iNO is also associated with the risk of exposure to nitrogen dioxide and adverse events, such as methemoglobinemia. Furthermore, a complex and costly delivery system is required to administer iNO, meaning that it is not available in all parts of the world …”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, a complex and costly delivery system is required to administer iNO, meaning that it is not available in all parts of the world. 12 Iloprost (Ventavis 1 , Bayer Pharma AG, Berlin, Germany) is a stabilized prostacyclin analogue that may have potential in the acute treatment of postoperative PH in children and neonates, but clinical data are scarce. 13 Unlike iNO, iloprost can be administered as an intravenous infusion or can be inhaled by using a nebulizer, which can be incorporated into a ventilatory circuit for use in the intensive care setting.…”

Section: Introductionmentioning

confidence: 99%

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Iloprost for children with pulmonary hypertension after surgery to correct congenital heart disease

Zhu

Liu

et al. 2014

Pediatric Pulmonology

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Congenital heart disease (CHD) can cause pulmonary hypertension (PH) in children, and surgery to correct CHD may be complicated by postoperative pulmonary hypertensive crises (PHC). Clinical data regarding the use of inhaled iloprost to treat children with PH are scarce. Our aim was to determine the efficacy and safety of iloprost in children with PH following surgery to correct CHD. This was a randomized, placebo-controlled study of 22 children (median age 7 months) undergoing surgery to achieve biventricular repair. The combined clinical endpoint was a decrease of more than 20% in the ratio of systolic pulmonary arterial pressure to systolic arterial pressure or pulmonary resistance to systemic resistance, with no PHC or death. Patients were randomized to receive low-dose iloprost (30 ng/kg/min), high-dose iloprost (50 ng/kg/min), or placebo, for 10 min every 2 hr in the first 48 hr after surgery. PHC were experienced by two patients who received placebo and one patient treated with high-dose iloprost. The combined clinical endpoint was reached by six patients administered low-dose iloprost (P = 0.005) and four administered high-dose iloprost (P = 0.077), compared with none in the placebo group. Patients treated with iloprost showed a significant reduction from baseline in mean pulmonary vascular resistance index (-2.2 Wood units, P < 0.05), whereas patients who received placebo showed no significant change. This study supports the use of iloprost to treat children with PH following surgery to correct CHD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Iloprost for children with pulmonary hypertension after surgery to correct congenital heart disease

Zhu

Liu

et al. 2014

Pediatric Pulmonology

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Efficacy of different analgesic or sedative drug therapies in pediatric patients with congenital heart disease undergoing surgery: a network meta-analysis

Liu

Zhao

2019

World J Pediatr

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Intraoperative management of pulmonary arterial hypertension in infants and children

Galante¹

2009

Current Opinion in Anaesthesiology

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The first important aspect of anesthetic management is to provide adequate intraoperative anesthesia and analgesia while minimizing increases in pulmonary vascular resistance and myocardial function. Depending on the procedure, these goals can be met with the administration of either sedation/analgesia or general anesthesia together with new drugs for PAH treatment in association with a high potential for adverse events.

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Anesthetic management of children with pulmonary arterial hypertension

Cited by 5 publications

References 4 publications

Iloprost for children with pulmonary hypertension after surgery to correct congenital heart disease

Iloprost for children with pulmonary hypertension after surgery to correct congenital heart disease

Efficacy of different analgesic or sedative drug therapies in pediatric patients with congenital heart disease undergoing surgery: a network meta-analysis

Intraoperative management of pulmonary arterial hypertension in infants and children

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