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Efficacy and safety of endotracheal instillation of iloprost for persistent pulmonary hypertension of the newborn

Part of: Basic Science

Published online by Cambridge University Press:  06 January 2022

Asli Okbay Gunes Open the ORCID record for Asli Okbay Gunes [Opens in a new window] ,
Murat Ciftel Open the ORCID record for Murat Ciftel [Opens in a new window] ,
Mehmet Emcet Timur ,
Ceren Dedebali  and
Betul Zehra Pirdal
Asli Okbay Gunes*
Affiliation:
Neonatal Intensive Care Unit, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
Murat Ciftel
Affiliation:
Department of Pediatric Cardiology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
Mehmet Emcet Timur
Affiliation:
Neonatal Intensive Care Unit, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
Ceren Dedebali
Affiliation:
Neonatal Intensive Care Unit, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
Betul Zehra Pirdal
Affiliation:
Department of Public Health, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
*
Author for correspondence: Asli Okbay Gunes, MD, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey. Gsm: +90 546 241 37 39. E-mail: asliokbay@gmail.com
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Abstract

Objective:

To determine the efficacy and safety of endotracheal instillation of iloprost as a rescue therapy for persistent pulmonary hypertension of the newborn.

Methods:

Neonates diagnosed with persistent pulmonary hypertension who were unresponsive to standard treatment protocol applied for persistent pulmonary hypertension in our unit, and who were being followed up with mechanical ventilation, were included in the study. Iloprost was instilled endotracheally as a rescue treatment. Systolic pulmonary artery pressure, oxygen saturation index, mean airway pressure, fraction of inspired oxygen, preductal and postductal venous oxygen saturation, heart rate, and blood pressure were recorded before and after 30 minutes of endotracheal iloprost instillation. Adverse events after endotracheal iloprost were recorded.

Results:

Twenty neonates were included. The median gestational age and birth weight were found to be 37 (30.5-38) weeks and 2975 (2125-3437.5) grams, respectively. When compared to the period before endotracheal iloprost instillation, systolic pulmonary artery pressure, oxygen saturation index, mean airway pressure, and fraction of inspired oxygen values significantly decreased (p < 0.001, p < 0.001, p = 0.021, p = 0.001, respectively), whereas preductal and postductal oxygen saturation values significantly increased 30 minutes after the endotracheal iloprost instillation (p = 0.002, p < 0.001, respectively). There were no significant differences in heart rate and blood pressure values before and after the iloprost administration. No adverse events were observed.

Conclusion:

Endotracheal instillation of iloprost was found to be an effective and safe therapy for persistent pulmonary hypertension unresponsive to conventional treatment.

Keywords

Endotracheal iloprostNewbornsPulmonary hypertension
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 12 , December 2022 , pp. 1894 - 1900
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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