title: Continuous intravenous epoprostenol in pulmonary hypertension: the Israel experience.
abstract: BACKGROUND
  Primary idiopathic pulmonary hypertension is a rapidly progressive disease with a median survival of less than 3 years. Recently its prognosis was shown to dramatically improve with the use of epoprostenol, an arachidonic acid metabolite produced by the vascular endothelium, which increases the cardiac output and decreases the pulmonary vascular resistance and pulmonary arterial pressure. This drug enhances the quality of life, increases survival and delays or eliminates the need for transplantation.
  
  
  OBJECTIVE
  To review the experience of Israel hospitals with the use of epoprostenol.
  
  
  METHODS
  The study group comprised 13 patients, 5 men and 8 women, with an age range of 3-53 years. All patients suffered from arterial pulmonary hypertension. Epoprostenol was administered through a central line in an increased dose during the first 3 months, after which the dose was adjusted according to the clinical syndrome and the hemodynamic parameters.
  
  
  RESULTS
  After 3 months the mean dose was 10 ng/kg/min and the pulmonary artery pressure decreased from 7 to 38%. After one year, the PAP decreased at a slower rate. Two cases required transplantation, three patients died, and seven continued taking the drug (one of whom discontinued). Four episodes of septicemia were observed. Today 10 patients are alive and well and 7 continue to take epoprostenol.
  
  
  CONCLUSIONS
  We found that epoprostenol improves survival, quality of life and hemodynamic parameters, with minimum side effects.
authors: Pulmonary Institute, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.
authors: Daniele
authors: D
authors: Bendayan
authors: Gershon
authors: G
authors: Fink
authors: Dan
authors: D
authors: Aravot
authors: Mordechai
authors: M
authors: Ygla
authors: Issahar
authors: I
authors: Bendov
authors: Leonard
authors: L
authors: Bliden
authors: Amiran
authors: A
authors: Nir
authors: Mordechai R
authors: MR
authors: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002675:Child, Preschool; D011464:Epoprostenol / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006207:Half-Life; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D007262:Infusions, Intravenous; D007557:Israel; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol