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[Complications of prostaglandin E1 treatment of congenital heart disease in paediatric medical intensive care].
- Source :
-
Archives des maladies du coeur et des vaisseaux [Arch Mal Coeur Vaiss] 2005 May; Vol. 98 (5), pp. 524-30. - Publication Year :
- 2005
-
Abstract
- The authors undertook a retrospective study of the modes of prescription, the tolerance and efficacy of prostaglandin E1 in 62 consecutive neonates with congenital heart disease (average Age 1.6 days: 35 boys: weight: 3.1 +/- 0.6 Kg) admitted to the paediatric intensive care unit of Nancy University Hospital between 1998 and 2002. The infusion time and cumulative dosage were 134 +/- 112 (6-480) hours and 111 +/- 94 (4-396) microg/Kg respectively. The side effects that were observed were: Apnoea (19%), abdominal distension (16%), bradycardia (13%), enterocolitis (6.5%), hypotension (6.5%), vomiting (5%), fever (1.6%) and skin rash (1.6%). Gastrointestinal disturbances are associated with a low body weight (p<0.04), to prolonged treatment (p<0.02) with no influence of initial or cumulative dosages (P=NS), with respiratory assistance (p<0.03) and longer hospital stay (p<0.01). Hypotension was commoner in cases of poor neonatal adaptation. Mortality was correlated with severe initial acidosis (p<0.02), a low Apgar score, the initial prolonged use of high doses of prostaglandin (p<0.04), and the presence of severe valvular aortic stenosis or hypoplasia of the left heart (p<0.002). The authors conclude that treatment with prostaglandin is effective in the majority of cases despite the use of low maintenance doses (0.01 microg/Kg/min). Gastrointestinal disturbances favourised by the perinatal context, the cardiac disease, and prolonged treatment are significant factors for morbidity and mortality. The beneficial role of early neonatal enteral feeding was not demonstrated in this high risk population.
- Subjects :
- Apnea chemically induced
Body Weight
Enterocolitis chemically induced
Exanthema chemically induced
Female
France
Humans
Infant, Newborn
Intensive Care Units, Pediatric statistics & numerical data
Male
Retrospective Studies
Risk Factors
Vomiting chemically induced
Alprostadil adverse effects
Alprostadil therapeutic use
Heart Defects, Congenital drug therapy
Vasodilator Agents adverse effects
Vasodilator Agents therapeutic use
Subjects
Details
- Language :
- French
- ISSN :
- 0003-9683
- Volume :
- 98
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Archives des maladies du coeur et des vaisseaux
- Publication Type :
- Academic Journal
- Accession number :
- 15966603