Prostaglandin E1 in infants with congenital diaphragmatic hernia (CDH) and life-threatening pulmonary hypertension
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In brief
In brief
Study evaluates Prostaglandin E1 therapy in 18 newborns with severe CDH and life-threatening pulmonary hypertension characterized by suprasystemic pressures and right-to-left ductal shunting. PGE1 treatment significantly reduced FiO2 requirements and ductal flow velocities at 6 hours, suggesting potential benefit in managing acute cardiorespiratory decompensation in this high-risk population.
Written by the GCMD Library team from the article.
Background
Suprasystemic pulmonary hypertension (PH) is highly predictive of pulmonary morbidity and death in infants with congenital diaphragmatic hernia (CDH).
Objectives
To report the effects and tolerability of Prostaglandin E1 (PGE1) in newborns with severe CDH and life-threatening PH.
Methods
Newborn infants with isolated CDH and life-threatening PH defined by an acute worsening of the cardiorespiratory function, and bidirectional or exclusive right-to-left shunting across the ductus arteriosus (DA) with an acceleration of the blood flow >1.5 m.s−1 assessed by Doppler echocardiography. Serial measurements of cardiorespiratory variables have been recorded before and after PGE1.
Results
18 infants (out of 102 in the cohort) were included in the study (gestational age: 39 ± 2 weeks). The median FiO2, and preductal and postductal SpO2 were 80% [50; 100], 91% [88; 95] and 86% [82; 91], respectively, before treatment. FiO2 decreased to 35% [30–40] (p = 0.001) at H6. Maximal blood flow velocities in the DA decreased after starting PGE1 from 2.2 m.s−1 [1.5–2.5] to 1 m.s−1 [0.55–1.2] (p