Intravenous epoprostenol improves oxygenation index in patients with persistent pulmonary hypertension of the newborn refractory to nitric oxide
Intravenous epoprostenol improves oxygenation index in patients with persistent pulmonary hypertension of the newborn refractory to nitric oxide
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DOI：
10.1038/s41372-018-0179-7
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发表时间：
2018-09-01
影响因子：
2.9
通讯作者：
Powers, George Charles
中科院分区：
文献类型：
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作者：
Ahmad, Kaashif Aqeeb;Banales, Jesse;Powers, George Charles
ObjectiveEvaluate the short-term effects of IV epoprostenol in neonates with consistent pulmonary hypertension（PPHN）of newborn.Study Design我们回顾了2010年至2015年36例吸入性一氧化氮（iNO）难治性PPHN患者接受IV epoprostenol治疗。患者分为应答者和无应答者（死亡或需要体外膜肺氧合）。肺发育不全是PPHN的病因，57%的无应答者和13%的应答者。基线时的中位氧合指数（OI）相似（41.8无应答者vs. 36.5应答者，p = 0.41），治疗4 h时应答者的OI显著较低（42.3 vs. 23.1，p = 0.002）。依前列醇应答者4 h内OI中位数下降11.6（p = 0.017），显著应答持续至24 h。结论在iNO难治性PPHN婴儿中，开始IV依前列醇与应答者OI显著快速下降相关。
Objectives Evaluate the short-term effects of IV epoprostenol in neonates with persistent pulmonary hypertension (PPHN) of the newborn.Study Design We reviewed 36 patients with inhaled nitric oxide (iNO) refractory PPHN placed on IV epoprostenol from 2010 to 2015. Patients were categorized as responders or non-responders (who either died or required extracorporeal membranous oxygenation).Results There were 15 responders and 21 non-responders. Pulmonary hypoplasia was the etiology of PPHN for 57% of nonresponders vs. 13% of responders. Median oxygenation index (OI) was similar at baseline (41.8 non-responders vs. 36.5 responders, p = 0.41) with responders having a significantly lower OI by 4 h of treatment (42.3 vs. 23.1, p = 0.002). Epoprostenol responders had a median OI decrease of 11.6 within 4 h (p = 0.017) with a significant response persisting through 24 h.Conclusion In infants with iNO-refractory PPHN, initiation of IV epoprostenol was associated with a significant and rapid OI reduction among responders.