Persistent pulmonary hypertension of the newborn successfully treated with beraprost sodium: a retrospective chart review.
BACKGROUND
Persistent pulmonary hypertension of the newborn (PPHN) is one of the most serious conditions in neonates resulting in a high mortality and morbidity. New alternative therapies for PPHN have been sought to improve survival and reduce morbidity.


OBJECTIVE
To report an initial experience of using beraprost sodium (BPS) to treat infants with PPHN and to assess its effect on oxygenation and hemodynamic stability over a 72-hour study period.


METHODS
The clinical data of neonates who received BPS as an adjunctive therapy for PPHN in our hospital between July 2007 and June 2008 were retrospectively reviewed.


RESULTS
During the study period, 7 infants with PPHN were successfully treated with BPS. The mean gestational age and birth weight were 39.3 ± 1.5 weeks and 3,365.7 ± 569.8 g, respectively. BPS was initiated at a median age of 42.7 h after birth (range: 2.1-166.5 h) with a baseline mean oxygen index (OI) of 33.9 ± 15.7 and a baseline mean systolic blood pressure (SBP) of 79.4 ± 9.9 mm Hg. The mean difference of OI at 24, 48 and 72 h following the treatment was -15.7 ± 14.8 (p = 0.043), -18.2 ± 12.3 (p = 0.018) and -16.7 ± 17.5 (p = 0.042), respectively. The mean SBP was significantly reduced as early as 6 h after initiation of treatment (-11.1 ± 11.5 mm Hg, p = 0.034) without changes in heart rate. Three cases were complicated with chronic lung disease, and the remaining 4 cases were normal at hospital discharge. No neurodevelopmental and cardiopulmonary disorders were observed in all cases at 1 year of age.


CONCLUSIONS
BPS may be used as an alternative treatment for infants with PPHN giving a significant improvement in oxygenation.
Nakwan
Narongsak
N
Neonatal Intensive Care Unit, Departments of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand. nnakwan @ hotmail.com
Nakwan
Narongwit
N
Wannaro
Jeerawan
J
D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; C048081:beraprost; D011464:Epoprostenol