EVALUATION OF LOW-DOSE PROSTAGLANDIN E(1) TREATMENT FOR DUCTUS DEPENDENT CONGENITAL HEART-DISEASE

This study reports our experience with low-dose prostaglandin E(1) (PG E(1)) treatment of 91 newborns with ductus dependent congenital heart disease (CHD). PGE(1) efficacy, side-effects as well as the cardiovasc ular and respiratory profile of the patients were analysed. PGE(1) dos es > 0.02 mu g/kg per minute were used for only 5.3% of the total 23,6 56 h of treatment. The mean systolic blood pressures did not differ fr om the normal mean for patients with cyanotic CHD, while the diastolic values were lowered. Respiratory support was required only during 13. 7% of the total treatment time. Apnoeas occurred in 21 (38%) of the 55 spontaneously breathing infants, who all had a cyanotic CHD. The inci dence of apnoeas was lower during treatment with doses < 0.01 mu g/kg per minute. Conclusion PGE(1) can be successfully administered in lowe r doses than previously recommended. Especially high initial doses can be avoided and low maintenance doses allow long-term treatment withou t serious complications.