Successful Weaning From Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) After Initiation of Inhaled Epoprostenol in a Neonate With Refractory Persistent Pulmonary Hypertension of the Newborn (PPHN).
extracorporeal membrane oxygenation
inhaled epoprostenol
meconium aspiration syndrome
neonate
refractory pphn
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
25
07
2023
accepted:
20
09
2023
medline:
23
10
2023
pubmed:
23
10
2023
entrez:
23
10
2023
Statut:
epublish
Résumé
Despite improvements in the medical management of persistent pulmonary hypertension of the newborn (PPHN), a significant number of patients persist with inadequate gas exchange and are treated with extracorporeal membrane oxygenation (ECMO). Prolonged time to weaning ECMO can increase mortality risk. Therefore, multiple therapies are utilized for pulmonary hypertension treatment, including pharmacotherapy with pulmonary vasodilators, to improve the prognosis of these critical patients. We report a case of a 37 2/7-week neonate with severe PPHN refractory to triple pulmonary vasodilator therapy (inhaled nitric oxide (iNO), sildenafil, and milrinone) and required veno-venous (VV)-ECMO support to improve oxygenation. Our patient was successfully weaned from ECMO after the addition of inhaled epoprostenol (iEPO) therapy. This report indicates that inhaled prostacyclin therapy effectively helps refractory PPHN patients off extracorporeal life support (ECLS) and should be considered a valuable treatment.
Identifiants
pubmed: 37868379
doi: 10.7759/cureus.45595
pmc: PMC10588285
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e45595Informations de copyright
Copyright © 2023, Shehzad et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Pediatr. 2016 Oct;177:90-96.e3
pubmed: 27502103
Pediatr Crit Care Med. 2014 May;15(4):362-8
pubmed: 24583505
Semin Fetal Neonatal Med. 2015 Aug;20(4):262-71
pubmed: 25843770
J Pediatr. 2008 Sep;153(3):345-9
pubmed: 18534241
Respir Care. 2015 Jun;60(6):794-802; discussion 802-5
pubmed: 26070575
J Perinatol. 2018 Sep;38(9):1212-1219
pubmed: 30046179
Pediatr Cardiol. 2013;34(8):2027-9
pubmed: 23143352
Eur J Pediatr. 2021 Aug;180(8):2379-2387
pubmed: 34091748
Pediatr Res. 2004 Oct;56(4):579-85
pubmed: 15295081
Respir Med. 2010 Jan;104(1):9-21
pubmed: 19683911
Pulm Circ. 2012 Jan-Mar;2(1):61-6
pubmed: 22558521
Crit Care Med. 2004 Apr;32(4):1055-60
pubmed: 15071401
Am J Physiol. 1992 Feb;262(2 Pt 1):L214-22
pubmed: 1539677
Nitric Oxide. 2020 Feb 1;95:45-54
pubmed: 31870967
Ann Transl Med. 2021 Apr;9(7):597
pubmed: 33987295
Pediatr Pulmonol. 2014 Dec;49(12):1205-13
pubmed: 24420987
Semin Perinatol. 2016 Apr;40(3):160-73
pubmed: 26778236
Intensive Care Med. 2004 Mar;30(3):372-80
pubmed: 14722629
Pediatr Crit Care Med. 2010 Mar;11(2 Suppl):S79-84
pubmed: 20216169
Pediatrics. 2006 Jan;117(1):75-83
pubmed: 16396863
Eur Respir J. 2019 Aug 22;54(2):
pubmed: 31151956
J Surg Res. 2012 Oct;177(2):263-7
pubmed: 22901797
Paediatr Drugs. 2017 Jun;19(3):183-192
pubmed: 28374138
Pediatrics. 2000 Aug;106(2 Pt 1):344-5
pubmed: 10920164
J Crit Care. 2013 Oct;28(5):844-8
pubmed: 23683572
Respir Care. 2020 Oct;65(10):1611-1623
pubmed: 32973104
Circulation. 2015 Nov 24;132(21):2037-99
pubmed: 26534956