Purpose: Persistent pulmonary hypertension of the newborn (PPHN) is a disease with potential serious morbidity and mortality. Inhaled iloprost, a stable analogue of prostacyclin, has recently been used as a therapeutic option. However, there are no clinical guidelines on the use of iloprost, specifically for neonates. This study aimed to suggest the use of inhaled iloprost as a rescue therapy for PPHN based on our experience. Methods: This was a retrospective study. The data from medical records of 6 newborns (4 late preterm, 2 term), diagnosed as persistent pulmonary hypertension of the newborn and had received inhaled iloprost from December 2019 to November 2021 were collected. Demographic and clinical features, changes in PaO , FiO , oxygenization index, echocardiographic findings and mortality were evaluated. Results: The inhalation dose was 2 mcg/dose, and 1-48 inhalations per day were applied over 4-9 days. Inhaled iloprost was as effective as iNO in all the patients. No side effects attributable to inhaled iloprost and no mortality was recorded. Conclusion: Our experience suggests that inhaled iloprost can be used as a first-line therapy in newborn infants with PPHN when inhaled nitric oxide is not available.
Persistent pulmonary hypertension of the newborn (PPHN) is one of the diseases of the neonate with severe potential morbidity and mortality. Inhaled iloprost, a stable prostacyclin analog, has been suggested as an alternative treatment for inhaled nitric oxide (iNO). However, more data on neonates' dosing, setting, and effectiveness still needs to be solved. This study suggests using inhaled iloprost as rescue therapy for PPHN based on our experience. This was a retrospective study. The data from medical records of six newborns diagnosed with PPHN and had received inhaled iloprost from December 2019 to April 2022 were collected. Demographic and clinical features, dosing regimen, changes in oxygenation index, echocardiographic findings, and mortality were evaluated. The inhalation dose was 2−4 mcg/dose, and 3−48 inhalations per day were applied over 2−7 days. Inhaled iloprost was effective in all patients. No side effects were attributable to inhaled iloprost, and no mortality was recorded. Our experience suggests that inhaled iloprost can be used as a first‐line therapy in newborn infants with PPHN when iNO is unavailable. However, there are large fluctuations in the oxygenation index due to the setting.
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