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

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.

Publication types

  • Observational Study

MeSH terms

  • Administration, Inhalation
  • Cohort Studies
  • Female
  • Humans
  • Iloprost / therapeutic use*
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Persistent Fetal Circulation Syndrome / drug therapy*
  • Persistent Fetal Circulation Syndrome / etiology
  • Respiratory Distress Syndrome, Newborn / complications*
  • Retrospective Studies
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents
  • Iloprost

Supplementary concepts

  • Respiratory Distress Syndrome In Premature Infants