Unusual metabolism of prostacyclin in infants with persistent septic pulmonary hypertension.

In urine of healthy man, the major metabolite of prostacyclin is 2,3-dinor-6-oxo-prostaglandin F1 alpha. The excretion rates of this compound as well as of 2,3-dinor-thromboxane B2, a major metabolite of thromboxane A2, in two newborns with septic persistent pulmonary hypertension were about 30- to 50-fold higher than the normal range (2,3-dinor-6-oxo-prostaglandin F1 alpha: 3-15 ng/h/1.73 m2; 2,3-dinor-thromboxane B2: 8-25 ng/h/1.73 m2). The ratios of 2,3-dinor-6-oxo-13,14-dihydro-prostaglandin F1 alpha/2,3-dinor-6-oxo-prostaglandin F1 alpha in these two infants were about 100% and 800%, respectively whereas in controls the excretion of the 13,14-dihydro metabolite was found to be about 10-25% of 2,3-dinor-6-oxo-prostaglandin F1 alpha. Thus in patients with septic persistent pulmonary hypertension and extremely high excretion rates of prostacyclin and thromboxane A2 metabolites, the pattern of metabolites differs from those of healthy man.