title: The effect of intravenous iloprost on pulmonary artery hypertension after paediatric congenital heart surgery.
abstract: OBJECTIVE
  To investigate the effects of intravenous iloprost on pulmonary artery hypertension (PAH) in infants undergoing congenital heart surgery.
  
  
  METHODS
  In this prospective, randomized study, the study group (n = 15) received a continuous infusion of iloprost (2.0 ng/kg/min) that was delivered immediately after weaning from cardiopulmonary bypass and continued for 72 h postoperatively. Patients in the control group (n = 12) were managed conventionally. The groups were compared in terms of postoperative data, including systolic and mean pulmonary artery (PA) pressures, PA/systemic pressure ratio, lactate level, PAH crisis, ventilation time, reintubation and lengths of intensive care unit (ICU) and hospital stay. Transthoracic echocardiography was used to assess PA pressures at 1 day, 7 days and 30 days after surgery.
  
  
  RESULTS
  No mortality occurred. PAH crisis occurred in 2 (16.6%) patients in the control group and 4 (26.7%) patients in the study group (P = 0.53). Postoperative PA pressures and PA/systemic pressure ratios were similar between the groups (P > 0.05). The durations of ICU (P = 0.40) and hospital (P = 0.98) stays were similar between the groups. Echocardiographic studies demonstrated a significant decrease in postoperative PA pressures in the control (P = 0.001) and study (P = 0.0001) groups. However, no significant change was observed between the groups (P > 0.05). The Tukey multiple comparison test showed a significant decrease in PA pressures at each follow-up in both groups (P < 0.05).
  
  
  CONCLUSIONS
  Intravenous iloprost demonstrated no additional benefit over the conventional management of infants with PAH after repair of intracardiac defects. Clinicians may prefer other alternative agents in infants with a high risk of PAH crisis.
authors.affiliation: Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey selenibis@hotmail.com.
authors.forename: Ismihan Selen
authors.initials: IS
authors.lastname: Onan
authors.affiliation: Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
authors.forename: Erkut
authors.initials: E
authors.lastname: Ozturk
authors.affiliation: Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Yildiz
authors.affiliation: Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
authors.forename: Husnu Firat
authors.initials: HF
authors.lastname: Altin
authors.affiliation: Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey Present address: Faculty of Medicine, Department of Pediatric Cardiology, Acibadem Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Odemis
authors.affiliation: Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey Present address: Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Erek
mesh_terms: D006348:Cardiac Surgical Procedures; D004305:Dose-Response Relationship, Drug; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016285:Iloprost / Q000008:administration & dosage*; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost
keywords: Congenital heart surgery; Intravenous iloprost; Pulmonary arterial hypertension