Safety and tolerability of subcutaneous treprostinil in newborns with congenital diaphragmatic hernia and life-threatening pulmonary hypertension
| Autor: | Estelle Aubry, Thameur Rakza, Laurent Storme, L. Pognon, Dyuti Sharma, Sébastien Mur, E. Carpentier, F. Flamein, Pierre Tourneux |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Sildenafil Hypertension Pulmonary medicine.medical_treatment Gestational Age Pulmonary Artery 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine 030225 pediatrics medicine.artery Extracorporeal membrane oxygenation Humans Medicine Antihypertensive Agents business.industry Infant Newborn Infant Gestational age Congenital diaphragmatic hernia General Medicine medicine.disease Epoprostenol Pulmonary hypertension Tolerability chemistry Echocardiography Anesthesia Pediatrics Perinatology and Child Health Pulmonary artery Female Surgery Hernias Diaphragmatic Congenital business Follow-Up Studies Treprostinil medicine.drug |
| Zdroj: | Journal of Pediatric Surgery. 52:1480-1483 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2017.03.058 |
| Popis: | Prolonged pulmonary hypertension (PH) is highly predictive for pulmonary morbidity and death in infants with congenital diaphragmatic hernia (CDH).To report the effects and tolerability of subcutaneous treprostinil in newborns with severe CDH and late life-threatening PH.We recorded clinical and echocardiography data before and after starting subcutaneous treprostinil, on patients with severe CDH and late PH, refractory to inhaled nitric oxide and oral sildenafil.14 patients were treated with treprostinil (gestational age: 39.1±2.0weeks; birth weight: 3200±600g). Prior to treatment, the pre- and post-ductal SpO2 difference (Δ SpO2) was 14±10%. Treprostinil was initiated at a median age of 12days [5-157]. After starting treprostinil, ΔSpO2 decreased to 3% at day 7 (p0.05), and the mean blood flow velocities in the right pulmonary arteries increased by 110% (p0.05). 2 of the 14 patients died. At the age of follow up (12months to 3years), the 12 surviving infants were all weaned from respiratory support and discharged home.The subcutaneous treprostinil improves pulmonary hemodynamics and outcomes in infants with CDH and life-threatening PH. We suggest that the treatment should be considered in infants with severe CDH and late PH.Case series with no comparison group.Level IV. |
| Databáze: | OpenAIRE |
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