Prostaglandin‐E1 infusion in persistent pulmonary hypertension of the newborn

Author:

Tsoi Stephanie M.1ORCID,Nawaytou Hythem2,Almeneisi Hassan2,Steurer Martina134,Zhao Yili2,Fineman Jeffrey R.15,Keller Roberta L.3

Affiliation:

1. Department of Pediatrics, Division of Critical Care Medicine University of California San Francisco San Francisco California USA

2. Department of Pediatrics, Division of Cardiology University of California San Francisco San Francisco California USA

3. Department of Pediatrics, Division of Neonatology University of California San Francisco San Francisco California USA

4. Department of Epidemiology and Biostatistics University of California San Francisco San Francisco California USA

5. Cardiovascular Research Institute University of California San Francisco San Francisco California USA

Abstract

AbstractBackgroundNeonates with persistent pulmonary hypertension of the newborn (PPHN) can present with hypoxia and right ventricular dysfunction with resultant inadequate oxygen delivery and end‐organ damage. This study describes the use of prostaglandin‐E1 (PGE) for ductal patency to preserve right ventricular systolic function and limit afterload in newborns with PPHN.MethodsThis is a retrospective cohort study that follows the hemodynamics, markers of end‐organ perfusion, length of therapeutics, and echocardiographic variables of 57 newborns who used prostglandin‐E1 in the setting of PPHN.ResultsTachycardia, lactic acidosis, and supplemental oxygen use improved following PGE initiation. Fractional area change (FAC), to assess right ventricular systolic function, and pulmonary arterial acceleration time indexed to right ventricular ejection time (PAAT/RVET), to assess right ventricular afterload, also improved over three time points relative to PGE use (before, during, and after).ConclusionsOverall, we described the safety and utility of PGE in newborns with severe PPHN for stabilization while allowing natural disease progression.

Funder

National Institutes of Health

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine,Pediatrics, Perinatology and Child Health

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