Document Detail


Prostaglandin E1: first stage palliation in neonates with congenital cardiac defects.
MedLine Citation:
PMID:  10771966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
E-type prostaglandins (PGE1) can effectively maintain the patency of the ductus arteriosus in neonates. Its use, therefore can be life saving in infants born with ductus dependent congenital heart disease. Although PGE1 is available for over two decades in western world, it has been introduced in India only since April, 1995. Various cardiac defects where PGE1 is useful include (a) lesions with ductus dependent pulmonary blood flow e.g. pulmonary atresia with or without ventricular septal defect, critical valvular pulmonic stenosis etc, (b) lesions with ductus dependent systemic blood flow e.g. critical aortic stenosis, coarctation of aorta, interruption of aortic arch etc, and (c) admixture lesions like transposition of great arteries. The drug is given as a continuous intravenous infusion. The initial dose is 0.05 to 0.4 ug/kg/min, infusion rate must be decreased to 0.01 ug/kg/min as soon as the desired effect is achieved as incidence of side effects is more at higher doses. Serious side effects include apnoea, hypotension, hyperthermia, seizures etc. We have used this drug in 43 infants ranging in age from one to forty five days. Beneficial response was seen in 41 of 43 infants and the major side effect was apnoea (seen in 5 of 32 spontaneously breathing infants). Unfortunately the high cost of the drug prohibits its wide spread and long term use. PGE1 is a life saving drug for infants born with ductus dependent congenital cardiac malformations. It helps in stabilizing these patients prior to further surgical palliation or correction.
Authors:
S C Reddy; A Saxena
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  65     ISSN:  0019-5456     ISO Abbreviation:  Indian J Pediatr     Publication Date:    1998 Mar-Apr
Date Detail:
Created Date:  2000-05-09     Completed Date:  2000-05-09     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  211-6     Citation Subset:  IM    
Affiliation:
Division of Pediatric Cardiology, Cardiothoracic Science Centre, AIIMS, Ansari Nagar, New Delhi.
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MeSH Terms
Descriptor/Qualifier:
Alprostadil / administration & dosage*,  adverse effects
Dose-Response Relationship, Drug
Ductus Arteriosus, Patent / drug therapy
Heart Defects, Congenital / drug therapy*
Humans
Infant
Infant, Newborn
Infusions, Intravenous
Palliative Care*
Vasodilator Agents / administration & dosage*,  adverse effects
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 745-65-3/Alprostadil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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