Prostacyclin aerosol in an infant with pulmonary hypertension

?antak, Borislav; Schreiber, Markus; Kuen, Peter; Lang, D.; Radermacher, P.

doi:10.1007/s004310050283

Cited by 20 publications

(3 citation statements)

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“…The half-life of PGI 2 is short because it undergoes a spontaneous hydrolysis to its stable metabolite, 6-keto-PGF 1 -alpha [92]. Thus, aerosolized PGI 2 has been shown to cause a selective decrease in pulmonary artery pressure, whereas IV PGI 2 caused decreases in pulmonary and systemic pressures in a 4-month-old infant with primary pulmonary hypertension [95]. Bindl et al [96] reported that aerosol PGI 2 , in a dose of 20 to 28 ng/kg/min, improved oxygenation and decreased pulmonary artery pressure measured by Doppler echocardiography without affecting the systemic pressure.…”

Section: Prostacyclinmentioning

confidence: 96%

New approaches for persistent pulmonary hypertension of newborn

Konduri

2004

Clinics in Perinatology

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Section: Prostacyclinmentioning

confidence: 96%

New approaches for persistent pulmonary hypertension of newborn

Konduri

2004

Clinics in Perinatology

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“…[ 9 ] Aerosolized or inhalational administration of epoprostenol offers the potential for more selective pulmonary vasodilatation with minimal impact on systemic systolic blood pressure (SBP). [ 10 ] In addition, ventilation/perfusion (V/Q) matching could be improved since lung units with the best ventilation will have more medication exposure. Use of inhaled epoprostenol for PPHN has been reported to improve oxygenation and decrease PAP by Doppler echocardiography without effects on SBP.…”

Section: Introductionmentioning

confidence: 99%

Inhaled Epoprostenol Therapy for Pulmonary Hypertension: Improves Oxygenation Index More Consistently in Neonates than in Older Children

et al. 2012

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The purpose of this study was to determine the efficacy of inhaled epoprostenol for treatment of acute pulmonary hypertension (PH) in pediatric patients and to formulate a plan for a prospective, randomized study of pulmonary vasodilator therapy in this population. Inhaled epoprostenol is an effective treatment for pediatric PH. A retrospective chart review was conducted of all pediatric patients who received inhaled epoprostenol at a tertiary care hospital between October 2005 and August 2007. The study population was restricted to all patients under 18 years of age who received inhaled epoprostenol for greater than 1 hour and had available data for oxygenation index (OI) calculation. Arterial blood gas values and ventilator settings were collected immediately prior to epoprostenol initiation, and during epoprostenol therapy (as close to 12 hours after initiation as possible). Echocardiograms were reviewed during two time frames: Within 48 hours prior to therapy initiation and within 96 hours after initiation. Of the 20 patients in the study population, 13 were neonates, and the mean OI for these patients improved during epoprostenol administration (mean OI before and during therapy was 25.6±16.3 and 14.5±13.6, respectively, P=0.02). Mean OI for the seven patients greater than 30 days of age was not significantly different during treatment (mean OI before and during therapy was 29.6±15.0 and 25.6±17.8, P=0.56). Improvement in echocardiographic findings (evidence of decreased right-sided pressures or improved right ventricular function) was demonstrated in 20% of all patients. Inhaled epoprostenol is an effective therapy for the treatment of selected pediatric patients with acute PH. Neonates may benefit more consistently from this therapy than older infants and children. A randomized controlled trial is needed to discern the optimal role for inhaled prostanoids in the treatment of acute PH in childhood.

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“…The findings in this study suggest caution in the administration of high volumes of aerosolized glycine diluent during IAP therapy. The two other animal studies 22,23 contradict the findings of this study, as does the well-documented, widespread, safe use of IAP in humans 1,2,5,[7][8][9][10]12,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] . IAP has also been given safely to healthy volunteers 2,5 .…”

Section: Discussionmentioning

confidence: 40%

Pulmonary Toxicity of Inhaled Aerosolized Prostacyclin Therapy—An Observational Study

Heerden

Caterina

Filion

et al. 2000

Anaesth Intensive Care

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Large white/landrace piglets (mass 11 to 21 kg) were exposed to aerosolized alkaline glycine diluent (n=2) or inhaled aerosolized prostacyclin (n=2) for five to eight hours. Pigs receiving these aerosols developed mild acute sterile tracheitis, involving the superficial layers of the trachea, shown histologically and ultrastructurally. Pigs receiving the diluent aerosol also showed mild inflammatory changes in the bronchioles. These findings suggest caution with the use of high volumes of aerosolized alkaline glycine diluent during inhaled aerosolized prostacyclin therapy.

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Prostacyclin aerosol in an infant with pulmonary hypertension

Cited by 20 publications

References 0 publications

New approaches for persistent pulmonary hypertension of newborn

New approaches for persistent pulmonary hypertension of newborn

Inhaled Epoprostenol Therapy for Pulmonary Hypertension: Improves Oxygenation Index More Consistently in Neonates than in Older Children

Pulmonary Toxicity of Inhaled Aerosolized Prostacyclin Therapy—An Observational Study

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