Analysis of the Factors That Influence on the Effect of Prostaglandin E1(PGE1)in Infants with Ductus-Dependent Cyanotic Congenital Heart Disease.
10.4070/kcj.1994.24.6.841
- Author:
Jong Kyun LEE
;
Seok Min CHOI
;
Jo Won JUNG
;
Jun Hee SUL
;
Sung Kyu LEE
- Publication Type:Original Article
- Keywords:
Prostaglandin E1;
Ductus arteriosus;
Cyanotic congenital heart disease
- MeSH:
Alprostadil;
Blalock-Taussig Procedure;
Blood Gas Analysis;
Cardiology;
Ductus Arteriosus;
Heart Defects, Congenital*;
Humans;
Infant*;
Infant, Newborn;
Infusions, Intravenous;
Oxygen;
Pulmonary Artery
- From:Korean Circulation Journal
1994;24(6):841-847
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The prostaglandin E1(PGE1) is a well known protent dilator of arteriosus. Maintaining of the patency of ductus arteriosus is crucial for the survival of patients suffering from ductus-dependent cyanotic congenital heart disease. We aimed to analyse the efficacy and the influencing factors upon PGE1 in patients suffering from this disease. METHODS: Between May 1991 and April 1993, 26 neonates and infants with ductus- dependent cyanotic congenital heart disease received on intravenous infusion of PGE1 in the Division of Pediatric Cardiology. Yonsei Cardiovascular Center. The result was a dramatic improvement in systemic arterial oxygen tension and oxygen saturation during infusion of PGE1with a dependency on the infusion of PGE1. We evaluated the arterial blood gas analysis both at the immediate pre-infusion stage and 2 hours after infusion. We aimed to analyse the factors which may influence the intravenous of PGE1to infant suffers of ducts-dependent cyanotic congenital heart disease, such as pulmonary atresia(n=14), severe pulmonary stenosis(n=7) or complete transposition of the great arteries(n=5). RESULTS: 1) There was a significant increase in PaO2 and Oxygen saturation 2 hours after the infusion of PGE1. This appeared to be unrelated to the different forms of the disease when compared with the pre-infusion values. 2) The infants' responsiveness of the ductus arteriosus appeared to be age related with significant differences emerging between the 2 group(p<.05). In infants younger than 9 hours old, the differences in PaO2 changes between pre-infusion and post-infusion of PGE1 were 16.3+/-3.7mmHg compared to just 10.4+/-0.4mmHg in infants older than 96 hours. 3) No significant difference emerged between an increase in PaO2or oxygen saturation relating to the shape of ductus arteriosus ; or the level of PaO2prior to the infusion. 4) The side effects of PGE1were as follows ; fever(84.6%),loose stool(61.5%), apnea(30.8%) and hypotension(15.4%), etc.. CONCLUSION: PGE1provides excellent medical palliation for infants suffering from ductus-dependent cyanotic congenital heart disease until the pulmonary arteries are large enough for a modified Blalock-Taussig shunt ; or until corrective surgery is possible.
