Iloprost inhalado: una alternativa terapéutica para la hipertensión pulmonar persistente del recién nacido

Guisán, Ana Concheiro; Rouco, C Sousa; Traba, B Suárez; Carreira, Andreia; Cardalda, S Ocampo; Cortizas, J. Antelo

doi:10.1157/13077463

Cited by 11 publications

(21 citation statements)

References 8 publications

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“…Nebulized prostacyclin can selectively dilate pulmonary vessels in ventilated lung regions with no effect on unventilated areas thereby decreasing intrapulmonary shunts (2,4). Only one other case has been published on iloprost use in neonates (7), although some experience exists about PGI 2 administration into the lungs (9,10). Iloprost is supposed to have some advantages over PGI 2 (7,10): it is not dissolved in an alkaline solution, potentially dangerous for the lung, it has a longer half-life and its effect is more prolonged (7,10).…”

Section: Casementioning

confidence: 99%

“…Only one other case has been published on iloprost use in neonates (7), although some experience exists about PGI 2 administration into the lungs (9,10). Iloprost is supposed to have some advantages over PGI 2 (7,10): it is not dissolved in an alkaline solution, potentially dangerous for the lung, it has a longer half-life and its effect is more prolonged (7,10). The positive effect of iloprost may depend on underlying pathology (1,2,4); in fact, it was less evident in CDH which is associated with pulmonary hypoplasia.…”

Section: Casementioning

confidence: 99%

“…Iloprost is a prostacyclin-analog with interesting pharmacological characteristics but few data are available about its use in neonatal critical care: to our knowledge, only a single case of PPHN secondary to meconium aspiration has been treated with iloprost and it was published in Spanish (7). We aimed to describe two neonates affected by secondary PPHN in which iloprost (ENDOPROST Ò , Schering AG, Berlin, Germany) was given in aliquots of 1 lg nebulized every 4 h.…”

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confidence: 99%

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Iloprost as ‘rescue’ therapy for pulmonary hypertension of the neonate

Luca

Zecca

Piastra

et al. 2006

Pediatric Anesthesia

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Section: Casementioning

confidence: 99%

Section: Casementioning

confidence: 99%

mentioning

confidence: 99%

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Iloprost as ‘rescue’ therapy for pulmonary hypertension of the neonate

Luca

Zecca

Piastra

et al. 2006

Pediatric Anesthesia

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“…Iloprost is recently approved for treatment of pulmonary arterial hypertension in adults. It has also shown to improve oxygenation in neonates with PPHN [56]. Recently, Beraprost sodium, an orally active, stable prostacyclin analogue, has shown significant improvement in oxygenation in infants with PPHN [57].…”

Section: Prostacyclin Iloprost and Beraprost Sodiummentioning

confidence: 99%

Persistent Pulmonary Hypertension of the Newborn: Recent Advances in the Management

Agarwal

2013

Int J Clin Pediatr

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Persistent pulmonary hypertension of the newborn (PPHN) is a medical emergency in the neonatal period, which occurs due to failure of normal postnatal transition of fetal circulation. Despite availability of numerous treatment modalities, associated mortality and morbidity remain high. Therefore, awareness of predisposing conditions, and early diagnosis and management may help improving outcome in PPHN. To provide an overview of anatomic and functional anomalies of PPHN, and available treatment options with special focus on recent advances in the diagnosis and management of this potentially lethal illness. MEDLINE, EMBASE, The Cochrane Library, and Google Scholar databases were searched (inception until Nov-2012) using terms "persistent pulmonary hypertension of newborn", "hypoxemic respiratory failure", "nitric oxide", "sildenafil", "milrinone" and "prostacyclin" without any language restriction. www.clinicaltrials.gov website was searched for relevant ongoing trials. Additionally, manual review of article bibliographies was done for potentially relevant studies. Strategies for the management of PPHN are undergoing metamorphosis. Gentle ventilation and high-frequency ventilation have replaced prior hyperventilation strategy. Currently, iNO is the only FDA-approved selective pulmonary vasodilator for infants with hypoxemic respiratory failure/PPHN; however, it has poor/no response in upto 30% cases. Recent studies have provided evidences for the use of other therapeutic agents such as PDE-inhibitors, magnesium sulphate and prostacyclin analogues. Finally, recent laboratory studies have demonstrated the role of oxidant stress as well as potential use of free radical scavengers for example, superoxide dismutase and catalase in the management of PPHN. Assisted ventilation and pharmacologic manipulation are the mainstays of treatment of PPHN. Limited availability of the gold standard treatment option namely iNO, especially in resource-limited countries, leads to increasing use of alternative therapeutic options such as PDE-inhibitors (sildenafil and milrinone). However, as any single therapy can not be labelled as a magic bullet for PPHN, further clinical trials are required to demonstrate the efficacy and safety of available therapeutic options as well as to develop newer strategies targeted to the underlying pathophysiology.

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“…Iloprost is an analogue of prostacyclin with greater chemical stability (16). There are a number of reports which have addressed the use of inhaled iloprost inhalation therapy for pulmonary hypertension of the newborn in the literature (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). 1-2 mcg/kg/dose, every 1-4 hours is the most used dose.…”

Section: Introductionmentioning

confidence: 99%

Inhaled iloprost is an effective alternative therapy for persistent pulmonary hypertension of the newborn

Yıldırım¹

2022

Preprint

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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.

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Iloprost inhalado: una alternativa terapéutica para la hipertensión pulmonar persistente del recién nacido

Cited by 11 publications

References 8 publications

Iloprost as ‘rescue’ therapy for pulmonary hypertension of the neonate

Iloprost as ‘rescue’ therapy for pulmonary hypertension of the neonate

Persistent Pulmonary Hypertension of the Newborn: Recent Advances in the Management

Inhaled iloprost is an effective alternative therapy for persistent pulmonary hypertension of the newborn

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