Related Experiment Video
Updated: Mar 31, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Prostaglandin Availability and Association with Outcomes for Infants with Congenital Heart Disease
Brady S Moffett1, Joshua M Garrison1,2, Aimee Hang1,2
1Department of Pharmacy, Texas Children's Hospital, Houston, TX, USA.
Insights
Prostaglandin E1 (PGE) is not available in all Texas hospitals. Lack of PGE availability in outlying hospitals is linked to increased infant morbidity for congenital heart disease but not mortality.
Area of Science:
- Pediatric Cardiology
- Neonatal Care
- Congenital Heart Disease Research
Background:
- Prostaglandin E1 (PGE) is crucial for stabilizing infants with ductal-dependent congenital heart disease.
- Data on PGE availability and its impact on clinical outcomes in Texas is limited.
- Understanding PGE accessibility is vital for improving care for critically ill newborns.
Purpose of the Study:
- To assess the availability of PGE in Texas hospitals in 2011.
- To investigate the association between PGE stocking and clinical outcomes in infants with ductal-dependent congenital heart disease.
- To identify factors influencing PGE availability in healthcare institutions.
Main Methods:
- Survey of all Texas birth institutions regarding PGE stocking in 2011.
- Retrospective analysis of infant outcomes (2007-2012) receiving PGE for ductal-dependent lesions.
- Comparison of clinical outcomes based on PGE availability at the birth hospital.
Main Results:
- PGE was stocked in 50% of Texas hospitals performing deliveries, serving 79.1% of births.
- Hospitals without PGE had fewer annual births and were farther from pediatric cardiac surgical centers.
- Infants born where PGE was unavailable showed significantly higher serum lactate and creatinine levels.
- PGE availability was not linked to length of stay or mortality, but morbidity increased in its absence.
Conclusions:
- PGE is not universally stocked in all healthcare facilities providing obstetrical services.
- Lack of PGE at outlying hospitals correlates with increased infant morbidity, particularly higher lactate and creatinine levels.
- While not impacting mortality or length of stay, PGE availability is a critical factor in managing neonatal congenital heart disease.
Abstract:
Data regarding availability of prostaglandin E1 (PGE) and its impact on the stabilization, transport, critical care course, and surgical outcome of infants with ductal-dependent congenital heart disease in the current pediatric healthcare environment are unknown. We sought to determine the proportion of hospitals in Texas that stock PGE and to investigate associations between PGE availability and clinical outcomes. All birth institutions listed with the Texas Department of Health and Human Services were contacted to determine PGE availability as of 2011. Outcomes of all infants admitted to our institution from 2007 to 2012 who received PGE for ductal-dependent lesions were evaluated. PGE was stocked in 50 % (n = 139) of hospitals that performed deliveries in Texas in 2011 representing 79.1 % (303, 481) of births. Hospitals that did not stock PGE had less annual births and were located a further distance from a center that provided pediatric cardiac surgical services. Patients born at a hospital that did not stock PGE had significantly greater serum lactate and creatinine (p = 0.002) and serum lactate on admission (p < 0.001). The PGE availability was not associated with hospital length of stay, postoperative length of stay, or mortality. When stratifying in TGA and HLHS subgroups, lack of PGE availability remained associated with higher creatinine, higher lactate, lower glucose, and lower pH. PGE is not universally available in all healthcare institutions providing obstetrical services. Lack of availability of PGE at an outlying hospital was associated with increased morbidity, but was not associated with mortality or length of stay.
More Related Videos
Related Concept Videos
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:19Mitral Valve Prolapse III: Nursing Management
01:21Intrauterine Drug Delivery Systems
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
01:07Teratogenicity