Abstract
Prostaglandin E1 (PGE1) has been used to maintain the patency of the ductus arteriosus when a shunt is required for adequate pulmonary blood flow or for oxygenation of the systemic blood. Previously an infusion of 0.1ug/kg/min has been used to stabilize infants temporarily prior to surgery. Maximum reported infusion time has been 4 days. Side effects such as apnea and hyperthermia may occur. In the past 5 months, we have used PGE1 in 5 infants with right or left sided obstructive lesions. In one infant with transposition of the great vessles and high pulmonary pressure after a balloon septostomy, we infused PGE1 intermittently for 18 days in an effort to increase pulmonary blood flow. Multiple attempts to wean the infant from PGE1 resulted in marked hypoxemia. Selected results from the 18 day infusion are shown below:
On days 16-20, the infant maintained an excellent pO2 on far less than the recommended dose and gradually could be weaned from the drug without developing acidosis. Side effects noted at 0.1ug/kg/min did not occur at low doses. This experience suggests that 1)long-term infusion of PGE1 may be a feasible way to manage small infants with certain complex cardiac conditions who are not deemed suitable for corrective surgery early in life and 2)an adequate response with fewer side effects may be realized at lower doses.
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Ivey, H., Wells, H., Kattwinkel, J. et al. 121 PROLONGED USE OF PROSTAGLANDIN E1 TO MAINTAIN PATENCY OF THE DUCTUS ARTERIOSUS IN CONGENITAL HEART DISEASE. Pediatr Res 12 (Suppl 4), 384 (1978). https://doi.org/10.1203/00006450-197804001-00126
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DOI: https://doi.org/10.1203/00006450-197804001-00126