Hammerman C, Arcilla R, Bui K C
Department of Pediatrics, University of Chicago Medical Center, Illinois.
Pediatr Cardiol. 1991 Apr;12(2):74-7. doi: 10.1007/BF02238406.
It was hypothesized that it is the concentration of PGE in the plasma which actually reaches the ductus arteriosus which determines ductal response to PGE administration. Therefore, site specific PGE levels were studied in two infants with ductus dependent congenital heart lesions who were receiving PGE1 infusions. PGE levels were found to vary in a fashion related to the infusion site and the specific cardiac anatomy and hemodynamics of each patient. One of our patients, for instance, had a double outlet right ventricle with high pulmonary vascular resistance and right to left ductal shunting. This infant was given an intraarterial infusion of PGE. The plasma concentrations of PGE in the ductal blood of the infant were negligible. Assuming that ductal site specific PGE levels are critical in mediating the therapeutic response, hemodynamics and infusion site are factors that should be considered when initiating a PGE infusion, or in evaluating a therapeutic failure of PGE.
据推测，实际上到达动脉导管的血浆中PGE的浓度决定了导管对PGE给药的反应。因此，对两名患有依赖动脉导管的先天性心脏病变且正在接受PGE1输注的婴儿进行了特定部位PGE水平的研究。发现PGE水平的变化方式与输注部位以及每位患者的特定心脏解剖结构和血流动力学有关。例如，我们的一名患者有右心室双出口，伴有高肺血管阻力和右向左导管分流。该婴儿接受了动脉内PGE输注。该婴儿导管血中PGE的血浆浓度可忽略不计。假设导管特定部位的PGE水平在介导治疗反应中至关重要，那么在开始PGE输注或评估PGE治疗失败时，血流动力学和输注部位是应考虑的因素。
