title: Effect of prostaglandin duration on outcomes in transposition of the great arteries with intact ventricular septum.
abstract: OBJECTIVE
  To study the effects of duration of preoperative prostaglandin E1 (PGE) exposure on perioperative outcomes of the arterial switch operation in patients with transposition of the great arteries with an intact ventricular septum.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Pediatric cardiac intensive care unit in a tertiary care children's hospital.
  
  
  METHODS
  All patients with transposition of the great arteries with an intact ventricular septum from 1995 to 2008.
  
  
  METHODS
  Inotropic score was calculated for all patients in the first 5 postoperative days and maximum inotropic score was recorded. Length of postoperative mechanical ventilation, fluid balance, mechanical ventilation time, as well as intensive care unit and hospital stay were recorded for all patients.
  
  
  RESULTS
  Study population included 59 patients, 41 (69%) underwent balloon atrial septostomy. PGE was used in 52 patients, median exposure of 59 hours, range 0 to 272 hours. Longer preoperative PGE exposure was associated with longer preoperative mechanical ventilation (P < .001). There was no association between preoperative PGE duration and cardiopulmonary bypass time, cross-clamp time, or total hospital stay. Patients with longer preoperative PGE exposure had a lower postoperative inotrope score (10 vs. 15 P = .02).
  
  
  CONCLUSIONS
  Greater preoperative PGE exposure was associated with prolonged preoperative mechanical ventilation. Longer PGE exposure was associated with lower postoperative inotrope requirements. Aggressive efforts to avoid or shorten PGE infusion duration may not be warranted in this population.
authors.affiliation: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, SC 29425, USA. butts@musc.edu
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Butts
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Ellis
authors.forename: Scott M
authors.initials: SM
authors.lastname: Bradley
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hulsey
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Atz
mesh_terms: D000527:Alprostadil / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000527:Alprostadil