The use of prostaglandin E1 and Blalock-Taussig shunts in neonates with cyanotic congenital heart disease.
Six unselected neonates with cyanotic congenital heart disease and life-threatening degrees of arterial oxygen desaturation have been managed by a protocol that includes administration of prostaglandin E1 (PGE1) and early Blalock-Taussig shunting. In 5 patients (seven paired observations) partial pressure of arterial oxygen (PaO2) rose from 19 mm Hg to a mean of 32.9 mm Hg within 20 minutes of initiation of PGE1 (0.1 to 0.2 microgram/kg/hr), infused intravenously or through an aortic catheter placed at ductal level or with both methods. The nonresponsive patient was older than the patients showing a positive response (1 month versus 24 to 96 hours). Following catheterization, immediate palliative operation including a Blalock-Taussig shunt was carried out. Although all had a satisfactory PaO2 (mean, 49 mm Hg) postoperatively, the PGE1-nonresponsive patient experienced serious intraoperative bradycardia, hypotension, and acidosis in contrast to the PGE1-responsive group. In this study, the use of PGE1 was not associated with any apparent serious side effects.
D004341:Drug Evaluation; D004373:Ductus Arteriosus / Q000187:drug effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D008297:Male; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011459:Prostaglandins E, Synthetic / Q000008:administration & dosage / Q000627:therapeutic use*; D011651:Pulmonary Artery / Q000601:surgery; D011652:Pulmonary Circulation; D013348:Subclavian Artery / Q000601:surgery; D013997:Time Factors
D011459:Prostaglandins E, Synthetic; D010100:Oxygen