Prostaglandin E1 use during neonatal transfer: potential beneficial role in persistent pulmonary hypertension of the newborn

Gupta, Neelam; Kamlin, CO; Cheung, Michael; Stewart, Michael J.; Patel, Neil

doi:10.1136/archdischild-2012-303294

Cited by 21 publications

(16 citation statements)

References 6 publications

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“…The effects of PGE 1 on cardiorespiratory status and outcomes in this cohort were the focus of a separate analysis and report. Rates of ventilation and inotrope use did not differ between PGE 1 and noPGE 1 groups …”

Section: Demographic and Clinical Characteristicsmentioning

confidence: 81%

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Improving diagnostic accuracy in the transport of infants with suspected duct‐dependent congenital heart disease

Gupta

Kamlin

Cheung

et al. 2013

J Paediatrics Child Health

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Section: Demographic and Clinical Characteristicsmentioning

confidence: 81%

“…We have additionally analysed the effects of PGE 1 use in our cohort in a separate recently published report . PGE 1 use was not associated with increased use of invasive ventilation or inotropes, in either DDCHD or non‐DDCHD, including PPHN.…”

Section: Discussionmentioning

confidence: 99%

Improving diagnostic accuracy in the transport of infants with suspected duct‐dependent congenital heart disease

Gupta

Kamlin

Cheung

et al. 2013

J Paediatrics Child Health

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“…A retrospective cohort study of 142 infants between ≤10 days and ≥34 weeks of gestation revealed the use of prostaglandin E 1 in infants with PPHN is significantly associated with a shortened length of hospitalization. No statistically significant difference in mortality between PGE 1 ‐treated and non‐PGE 1 ‐treated infants was found.…”

Section: Therapy Of Pphnmentioning

confidence: 99%

Current and Future Treatments for Persistent Pulmonary Hypertension in the Newborn

Maibom

Hedegaard

Simonsen

et al. 2018

Basic Clin Pharma Tox

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Persistent pulmonary hypertension in newborn (PPHN) is a serious and possibly fatal syndrome characterized by sustained foetal elevation of pulmonary vascular resistance at birth. PPHN may manifest secondary to other conditions as meconium aspiration syndrome, infection and congenital diaphragmatic hernia. This MiniReview provides the reader with an overview of current and future treatment options for patients with PPHN without congenital diaphragmatic hernia. The study is based on systematic searches in the databases PubMed and Cochrane Library and registered studies on Clinicaltrials.gov investigating PPHN. Inhaled nitric oxide (iNO) is well documented for treatment of PPHN, but 30% fail to respond to iNO. Other current treatment options could be sildenafil, milrinone, prostaglandin analogues and bosentan. There are several ongoing trials with sildenafil, but evidence is lacking for the other treatments and/or for the combination with iNO. Currently, there is no evidence for effect in PPHN of other treatments, for example tadalafil, macitentan, ambrisentan, riociguat and selexipag used for pulmonary arterial hypertension in adults. Experimental studies in animal models for PPHN suggest effect of a series of approaches including recombinant human superoxide dismutase, L-citrulline, Rho-kinase inhibitors and peroxisome proliferator-activated receptor-γ agonists. We conclude that iNO is the most investigated and the only approved pulmonary vasodilator for infants with PPHN. In the iNO non-responders, sildenafil currently seems to be the best alternative either alone or in combination with iNO. Systematic and larger clinical studies are required for testing the other potential treatments of PPHN.

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“…In one retrospective analysis of infants with PPHN but without ductal dependent cardiac lesions, in whom PGE 1 was initiated during transport, PGE 1 treatment was associated with significantly shortened length of stay. The proposed mechanisms include the pulmonary vasodilator effects of PGE 1 and the advantage ductal patency offers in providing a bypass or pop-off that permits improved function in the otherwise volume and pressure loaded right ventricle 61 .…”

Section: Pulmonary Vasodilators Acting Via the Camp Pathwaymentioning

confidence: 99%

Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide

Lakshminrusimha

Mathew

Leach

2016

Seminars in Perinatology

177

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Inhaled nitric oxide (iNO) is approved for use in persistent pulmonary hypertension of the newborn (PPHN) but does not lead to sustained improvement in oxygenation in a third of patients with PPHN. Inhaled NO is less effective in the management of PPHN secondary to congenital diaphragmatic hernia (CDH), extreme prematurity and bronchopulmonary dysplasia (BPD). Intravenous pulmonary vasodilators such as prostacyclin, alprostadil, sildenafil and milrinone have been successfully used in PPHN resistant to iNO. Oral pulmonary vasodilators such as endothelin-receptor antagonist bosentan and phosphodiesterase-5 inhibitors such as sildenafil and tadalafil are used both during acute and chronic phase of PPHN. In the absence of infection, glucocorticoids may also be effective in PPHN. Many of these pharmacologic agents are not approved for use in PPHN and our knowledge is based on case reports and small trials. Large multicenter randomized controlled trials with long-term follow-up are required to evaluate pharmacologic strategies in PPHN.

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Prostaglandin E1 use during neonatal transfer: potential beneficial role in persistent pulmonary hypertension of the newborn

Cited by 21 publications

References 6 publications

Improving diagnostic accuracy in the transport of infants with suspected duct‐dependent congenital heart disease

Improving diagnostic accuracy in the transport of infants with suspected duct‐dependent congenital heart disease

Current and Future Treatments for Persistent Pulmonary Hypertension in the Newborn

Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide

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