Prostaglandin E1 in infants with congenital heart disease: Indian experience.

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dc.contributor.authorSaxena, Aen_US
dc.contributor.authorSharma, Men_US
dc.contributor.authorKothari, S Sen_US
dc.contributor.authorJuneja, Ren_US
dc.contributor.authorReddy, S Cen_US
dc.contributor.authorSharma, Ren_US
dc.contributor.authorBhan, Aen_US
dc.contributor.authorVenugopal, Pen_US
dc.date.accessioned1998-11-27en_US
dc.date.accessioned2009-05-27T05:00:06Z
dc.date.available1998-11-27en_US
dc.date.available2009-05-27T05:00:06Z
dc.date.issued1998-11-27en_US
dc.description.abstractBACKGROUND: E-type prostaglandins (PGE1) can effectively maintain the patency of the ductus arteriosus in neonates. Its use, therefore and be life saving in infants born with ductus dependent congenital heart disease. Although PGE1 is available for over two decade in western world, it has been introduced in India only since April, 1995. OBJECTIVE: To assess the efficacy of PGE1 at our center. SETTING: Hospital based. METHOD: 65 infants with ductus dependent congenital heart disease were included. Age at time of starting PGE1 infusion ranged from 18 hours to 39 days. Forty two of these were more than a week of age, 19 were more than 14 days, and two were above one month. PGE1 was started in an initial dose of 0.05 microgram/kg/min, decreased to 0.005-0.01 microgram/kg/min for maintenance. The indications for use of PGE1 were to increase pulmonary blood flow in 33 cases with pulmonary atresia, tricuspid atresia or critical pulmonic stenosis (Group I); to increase systemic blood flow in 15 cases with coarctation of aorta, hypoplastic left heart and interruption of aortic arch (Group II); to improve mixing in 13 cases of transposition of great arteries (Group III) and for improving the left ventricular volumes by keeping the duct open in 4 cases of transposition of great arteries with intact ventricular septum (Group IV). The efficacy of the drug was assessed by a rise on PaO2 and SaO2% determined for Group I & III, and by appearance of lower limbs pulses in Group II. Left ventricular volumes were serially measured by echocardiography in Group IV cases. RESULTS: The drug was successful in 62 of the 65 cases. There were two failures. One was a 39 days old baby with Ebstein's anomaly of tricuspid valve and pulmonary atresia and other was an eight days old baby with coarctation of aorta and renal failure. In addition, PGE1 could not be continued in another baby due to development of a linear skin rash locally. Side effects included apnea in 5 (9%) of 56 spontaneously breathing patients. Necrotizing enterocolitis, hyperpyrexia and jitteriness was sent in one case each. Six patients died. Two were related to PGE1, one due to failure, another due to its side effects. Definitive procedure were performed in 51 cases electively. PGE1 was used upto 13 days with sustained benefit. CONCLUSIONS: PGE1 is an effective drug for keeping the ductus open in infants with ductus dependent congenital heart disease. It can be used for neonates beyond the first week of life with efficacy. Apnea is a major side effect and close monitoring is essential.en_US
dc.description.affiliationCardiothoracic Center, All India Institute of Medical Sciences, New Delhi, India.en_US
dc.identifier.citationSaxena A, Sharma M, Kothari SS, Juneja R, Reddy SC, Sharma R, Bhan A, Venugopal P. Prostaglandin E1 in infants with congenital heart disease: Indian experience. Indian Pediatrics. 1998 Nov; 35(11): 1063-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/7250
dc.language.isoengen_US
dc.source.urihttps://indianpediatrics.neten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAlprostadil --pharmacologyen_US
dc.subject.meshDuctus Arteriosus, Patent --drug therapyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeart Defects, Congenital --drug therapyen_US
dc.subject.meshHemodynamics --drug effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshInfusions, Intravenousen_US
dc.subject.meshMaleen_US
dc.subject.meshStroke Volume --drug effectsen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVasodilator Agents --pharmacologyen_US
dc.titleProstaglandin E1 in infants with congenital heart disease: Indian experience.en_US
dc.typeClinical Trialen_US
dc.typeControlled Clinical Trialen_US
dc.typeJournal Articleen_US
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