Comparison between prostaglandin E1 and epoprostenol (prostacyclin) in infants after heart surgery. Issue 2 (August 1991)

• Record Type: Journal Article
• Authors: Kermode, J; Butt, W; Shann, F
• Is Part Of: Heart. Volume 66:Issue 2(1991)
• Page Start: 175
• Page End: 178
• Publication Date: 1991-08
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.66.2.175
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : OBJECTIVE--To study the dose response characteristics of prostaglandin E1 and epoprostenol (prostacyclin) and directly to compare their effectiveness as pulmonary vasodilators in infants with pulmonary hypertension. DESIGN--A crossover design with each patient receiving both drugs in random order. SETTING--Infants were studied in the intensive care unit while they were sedated, paralysed, and ventilated. PATIENTS--Twenty infants who had undergone corrective cardiac surgery and who were in sinus rhythm, had stable haemodynamic function, and had a pulmonary artery catheter in place. All infants were receiving dopamine and phenoxybenzamine. INTERVENTIONS--Baseline haemodynamic measurements were taken and an infusion of the first drug was started at the lowest dose: after 20 minutes the measurements were repeated and the dose increased. This protocol was repeated for all doses of both drugs: 10, 30, and 100 ng/kg/min of prostaglandin E1 and 5, 10, and 25 ng/kg/min of epoprostenol. Cardiac output was measured by the pulsed Doppler ultrasound method. MAIN OUTCOME MEASURES--Pulmonary and systemic vascular resistances were calculated from the cardiac output and compared by the Wilcoxon signed ranks test. RESULTS--Both prostaglandin E1 and epoprostenol were effective vasodilators: 5 ng/kg/min of epoprostenol was equivalent to 30 ng/kg/min of prostaglandin E1. CONCLUSIONS--Neither drug showed pulmonary specificity.