INHALED AEROSOLIZED PROSTACYCLIN AS A SELECTIVE PULMONARY VASODILATORFOR THE TREATMENT OF SEVERE HYPOXEMIA

Two case reports are presented where inhaled aerosolized prostacyclin (IAP) was used to good effect as a selective pulmonary vasodilator: it was used in the treatment of a patient with severe hypoxaemia seconda ry to amniotic fluid embolism and for hypoxaemia secondary to the acut e respiratory distress syndrome (ARDS) in a patient with acute on chro nic liver failure and intra-abdominal sepsis. An apparent dose-respons e curve is demonstrated in the second case. A dose of IAP of 30-40 ng/ kg/min produced an effect on oxygenation in the patient with liver fai lure equal to that seen at the maximal dose of (50 ng/kg/min). Reducti on in dose below 30 ng/kg/min resulted in a deterioration in oxygenati on towards baseline/pre-treatment levels. Inhaled aerosolized prostacy clin is a potent pulmonary vasodilator with little or no systemic hypo tensive effect, It is simple to administer and would appear to be a vi able alternative to inhaled nitric oxide.