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

Abstract

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.