Systemic levels following PGE1 inhalation in neonatal hypoxemic respiratory failure.
OBJECTIVE
To measure plasma prostaglandin E1 (PGE1) levels in newborns with hypoxemic respiratory failure (NHRF) following inhaled PGE1 (IPGE1), normal term newborns, and newborns with congenital heart disease (CHD) following intravenous PGE1.


METHODS
Twenty newborns with NHRF received IPGE1 by jet nebulizer in doses of 25, 50, 150, and 300 ng/kg/min followed by weaning. Blood for PGE1 assay using enzyme immunoassay was available in eight neonates with NHRF, 10 normal newborns, and three neonates with CHD.


RESULTS
There were no differences in PGE1 levels between cord arterial blood in normal newborns and baseline samples from newborns with NHRF. Oxygenation improved significantly following IPGE1 (p=0.024) in newborns with NHRF. No adverse events were identified. Although a reversible increase in PGE1 levels was detected following a dose of 50 ng/kg/min (p<0.05), there was no association between PGE1 levels and IPGE1 duration, PaO2, temperature, heart rate, and blood pressure.


CONCLUSIONS
A reversible increase in mean PGE1 levels was demonstrable at low doses of IPGE1 in babies with NHRF using a sensitive assay, suggesting effective drug delivery. Levels did not increase further with increasing dose or duration of administration, suggesting local action in the lungs and a lack of systemic spillover due to extensive pulmonary metabolism offering pulmonary selectivity.
Sood
Beena G
BG
Carman and Ann Adams Department of Pediatrics, Wayne State University, Hutzel Women's Hospital & Children's Hospital of Michigan, Detroit, MI 48201, USA. bsood@med.wayne.edu
Glibetic
Maria
M
Aranda
Jacob V
JV
Delaney-Black
Virginia
V
Chen
Xinguang
X
Shankaran
Seetha
S
D000280:Administration, Inhalation; D000527:Alprostadil / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000188:drug therapy; D006801:Humans; D000860:Hypoxia / Q000097:blood*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D010100:Oxygen / Q000097:blood; D012131:Respiratory Insufficiency / Q000097:blood*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*
D014665:Vasodilator Agents; D000527:Alprostadil; D010100:Oxygen