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吸入伊洛前列素治疗患有严重呼吸窘迫综合征和肺动脉高压的早产儿。

Inhaled iloprost in preterm infants with severe respiratory distress syndrome and pulmonary hypertension.

作者信息

Yilmaz Osman, Kahveci Hasan, Zeybek Cenap, Ciftel Murat, Kilic Omer

机构信息

Department of Pediatric Cardiology, District Training and Research Hospital, Erzurum, Turkey.

Department of Neonatal Intensive Care Unit, Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey.

出版信息

Am J Perinatol. 2014 Apr;31(4):321-6. doi: 10.1055/s-0033-1348949. Epub 2013 Jun 24.

Abstract

OBJECTIVE

Many vasodilator drugs, including inhaled iloprost, are used to treat insufficient pulmonary vasodilatation, which is the main issue in pulmonary hypertension in newborns.

STUDY DESIGN

The safety and efficacy of inhaled iloprost for the treatment of pulmonary hypertension were evaluated retrospectively in 15 preterm infants diagnosed with respiratory distress syndrome and pulmonary hypertension.

RESULTS

The infants were unresponsive to surfactant and conventional mechanical ventilation and thus were treated with inhaled iloprost. Oxygenation parameters and hypoxemia improved rapidly after treatment. There was no decline in systemic blood pressure, no need for increased doses of vasopressor, and no side effects during treatment. One patient died of sepsis during treatment.

CONCLUSION

In the treatment of severely sick premature babies with pulmonary hypertension, inhaled iloprost has high tolerability and a low incidence of systemic side effects. Based on the benefits of inhaled iloprost in preterm infants with pulmonary hypertension in this case series, further studies are required to evaluate its efficacy and safety in the preterm population.

摘要

目的

许多血管扩张药物,包括吸入用伊洛前列素,被用于治疗肺血管扩张不足,这是新生儿肺动脉高压的主要问题。

研究设计

对15例诊断为呼吸窘迫综合征和肺动脉高压的早产儿,回顾性评估吸入用伊洛前列素治疗肺动脉高压的安全性和有效性。

结果

这些婴儿对表面活性剂和传统机械通气无反应,因此接受吸入用伊洛前列素治疗。治疗后氧合参数和低氧血症迅速改善。治疗期间全身血压无下降,无需增加血管升压药剂量,也无副作用。1例患者在治疗期间死于败血症。

结论

在治疗患有肺动脉高压的重病早产儿方面,吸入用伊洛前列素具有高耐受性和低全身副作用发生率。基于本病例系列中吸入用伊洛前列素对早产儿肺动脉高压的益处,需要进一步研究以评估其在早产人群中的疗效和安全性。

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