Successful weaning from cardiopulmonary bypass with central venous prostaglandin E1 and left atrial norepinephrine infusion in patients with acute pulmonary hypertension

Abstract

In patients with refractory postoperative pulmonary hypertension, the combined administration of low-dose PGE1 in the right atrium and NE in the left atrium is an effective means to wean patients from cardiopulmonary bypass.

Noradrenaline for management of septic shock refractory to fluid loading and dopamine or dobutamine in full‐term newborn infants

“…Noradrenaline improved circulatory adaptation at birth in a newborn lamb with persistent pulmonary hypertension (20). Other data suggest that noradrenaline can improve cardiac performance in pulmonary hypertension (22,23). Our results are consistent with these studies as the O 2 need decreased during the noradrenaline infusion, suggesting that noradrenaline‐induced increase in aortic pressure may be associated with improvement of PPHN‐induced cardiac dysfunction.…”

New approaches for persistent pulmonary hypertension of newborn

“…PGE 1 was found to be an effective vasodilator in experimental pulmonary hypertension [98] and in adults with primary or postoperative pulmonary hypertension [99,100]. This effect was noted with inhaled and IV administration of PGE 1 , although the response to PGE 1 was not as striking as the response to PGI 2 in a canine model of pulmonary hypertension [101].…”

Management strategies for patients with pulmonary hypertension in the intensive care unit*

“…However, unlike phenylephrine, norepinephrine maintained or improved cardiac output in patients with pulmonary hypertension. Selective infusion of norepinephrine into the left atrium, combined with prostaglandin E 1 administration into the right atrium, has been useful in weaning patients with acute pulmonary hypertension from cardiopulmonary bypass (61). There are no data that such selective infusion is beneficial in other patient populations.…”