| The Effects of Lipo Prostaglandin E1(EglandinⓇ) in Patients with Ductus Dependent Congenital Heart Disease |
|
Sejung Sohn, Seong Ho Kim, Eun Jung Bae, In Seung Park |
|
Department of Pediatrics, Sejong General Hospital, Buchon, Korea |
| 동맥관의존성 선천성 심질환에서의 LipoPGE1(EglandinⓇ)의 효과 |
|
손세정, 김성호, 배은정, 박인승 |
|
부천세종병원 소아과 |
|
|
|
|
| Abstract |
Purpose
: The adverse reactions of prostaglandin E1(PGE1) are troublesome in the preoperative
management of critical patients with ductus dependent congenital heart disease, and a preparation
with less adverse reactions is preferable. The effects of Lipo PGE1, a new preparation of PGE1
contained in lipid microspheres, were compared with those of conventional PGE1(PGE1-CD).
Methods
: Lipo PGE1 was infused at a rate of 5 ng/kg/min in 19 patients, PGE1-CD at a rate
between 10 and 50 ng/kg/min in 15 patients. The effects of drugs were assessed in terms of
clinical response rate and overall safety.
Results
: Clinically, both treatment were effective in relieving cyanosis and hypoxemia except
in patients already having either a closed ductus or severe hypoxemia and acidosis. The
increments of PaO2 1 hour after infusion were 10.9 and 6.2 mmHg (p>0.1), respectively and
those 4 hours postinfusion were 16.0 and 7.8 mmHg(p<0.05), respectively. Even though there
was no significant difference in clinical response rate(78.9 vs 60.0%, p>0.1), the mean dose of
Lipo PGE1 at appearance of response was about 1/5 of that of PGE1-CD in overall patients and
also in patients with ductus dependent pulmonary circulation(6.7 vs 31.7 ng/kg/min, p<0.005).
The adverse reactions occurred in 52.6% of the patients given Lipo PGE1, while it was 86.7%
in those administered PGE1-CD(p<0.05). The adverse reactions in Lipo PGE1 group was much
less severe than that in PGE1-CD group. There was a significant difference in overall safety between
the two drugs(84.2 vs 40%, p<0.01). As the incidence of the adverse reactions increased
at dose over 5 ng/kg/min, the initial dose of 5 ng/kg/min seemed to be appropriate for Lipo
PGE1.
Conclusion
: Lipo PGE1 was effective at a lower dose than was PGE1-CD, and was associated
with fewer or less severe adverse reactions, and is therefore judged to be more suitable for
clinical use than conventional PGE1-CD. |
| Key Words:
Ductus, Congenital heart disease, Lipo prostaglandin E1 |
|
PDF Links
Download Citation
