Stephanie M. Tsoi, Hythem Nawaytou, Hassan Almeneisi, Martina Steurer, Yili Zhao, Jeffrey R. Fineman, Roberta L. Keller
University of California San Francisco.
United States
Pediatric Pulmonology
Pediatr Pulmonol 2023;
DOI: 10.1002/ppul.26759
Abstract
Background: Neonates 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.
Methods: This 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.
Results: Tachycardia, 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).
Conclusions: Overall, we described the safety and utility of PGE in newborns with severe PPHN for stabilization while allowing natural disease progression.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes