Aerosolized iloprost in the treatment of pulmonary hypertension in extremely preterm infants: a pilot study

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F Eifinger1, N Sreeram, K Mehler

  • 1Klinik und Poliklinik für Kinderheilkunde, Abteilung für Neonatologie, Klinikum der Universität zu Köln. frank.eifinger@uk-koeln.de

Klinische Padiatrie
|August 22, 2007
PubMed

Insights

Aerosolized iloprost improved oxygenation in premature infants with persistent pulmonary hypertension. This treatment may help extremely low-birthweight neonates with breathing difficulties after prolonged rupture of membranes.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Persistent pulmonary hypertension is a significant cause of mortality in premature infants with prolonged rupture of membranes.
  • Current treatments for this condition in extremely low-birthweight neonates are limited.

Purpose of the Study:

  • To evaluate the efficacy of aerosolized iloprost in treating persistent pulmonary hypertension in extremely low-birthweight neonates.
  • To assess the safety and impact of iloprost inhalation on oxygenation and pulmonary resistance.

Main Methods:

  • Four extremely low-birthweight neonates (23-25 weeks' gestation) with pulmonary hypertension due to prolonged rupture of fetal membranes received aerosolized iloprost.
  • Treatment involved 44-65 inhalations of 2 microg/kg b.w. iloprost within the first hour of life over several days, with single inhalations lasting 5 minutes.

Main Results:

  • Following the first iloprost inhalation, the PaO2/FiO2 ratio significantly increased from a mean of 65 to 194 mmHg.
  • Oxygenation requirements decreased within 7 days, and echocardiography demonstrated a reduction in pulmonary resistance.
  • No severe side effects on blood pressure or prolonged bleeding were observed.

Conclusions:

  • Aerosolized iloprost shows promise as an adjunctive treatment for improving oxygenation in extremely low-birthweight infants with persistent pulmonary hypertension under spontaneous breathing.
  • Further randomized clinical trials are necessary to confirm the role of iloprost in managing this critical condition.
Abstract

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