Successful Weaning From Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) After Initiation of Inhaled Epoprostenol in a Neonate With Refractory Persistent Pulmonary Hypertension of the Newborn (PPHN).
| Autor: | Shehzad I; Neonatology, Baylor Scott & White Health, Austin, USA., Banker A; Pediatric Cardiology, Baylor Scott & White Health, Temple, USA., Das B; Pediatric Cardiology, Baylor Scott & White Health, Temple, USA., Humayun A; Neonatology, Baylor Scott & White Health, Temple, USA., Wills H; Pediatric Surgery, Baylor Scott & White Health, Temple, USA., Raju M; Neonatology, Baylor Scott & White Health, Temple, USA., Vora N; Neonatology, Baylor Scott & White Health, Temple, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Sep 20; Vol. 15 (9), pp. e45595. Date of Electronic Publication: 2023 Sep 20 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.45595 |
| Abstrakt: | Despite improvements in the medical management of persistent pulmonary hypertension of the newborn (PPHN), a significant number of patients persist with inadequate gas exchange and are treated with extracorporeal membrane oxygenation (ECMO). Prolonged time to weaning ECMO can increase mortality risk. Therefore, multiple therapies are utilized for pulmonary hypertension treatment, including pharmacotherapy with pulmonary vasodilators, to improve the prognosis of these critical patients. We report a case of a 37 2/7-week neonate with severe PPHN refractory to triple pulmonary vasodilator therapy (inhaled nitric oxide (iNO), sildenafil, and milrinone) and required veno-venous (VV)-ECMO support to improve oxygenation. Our patient was successfully weaned from ECMO after the addition of inhaled epoprostenol (iEPO) therapy. This report indicates that inhaled prostacyclin therapy effectively helps refractory PPHN patients off extracorporeal life support (ECLS) and should be considered a valuable treatment. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Shehzad et al.) |
| Databáze: | MEDLINE |
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