Continuous intravenous epoprostenol in pulmonary hypertension: the Israel experience.
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.
Bendayan
Daniele
D
Pulmonary Institute, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.
Fink
Gershon
G
Aravot
Dan
D
Ygla
Mordechai
M
Bendov
Issahar
I
Bliden
Leonard
L
Nir
Amiran
A
Kramer
Mordechai R
MR
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
D000959:Antihypertensive Agents; D011464:Epoprostenol