IMPROVEMENT OF OXYGENATION INDUCED BY AEROSOLIZED PROSTACYCLIN IN A PRETERM INFANT WITH PERSISTENT PULMONARY-HYPERTENSION OF THE NEWBORN

Objective: Case report on the effect of inhaled prostacyclin in a pret erm infant (28 weeks gestational age) with respiratory distress syndro me complicated by marked hypoxemia due to persistent pulmonary hyperte nsion of the newborn. Treatment with surfactant, hyperventilation, and elevation of systemic blood pressure had failed to improve oxygenatio n. Measures: A solution containing 10 mu g PGI(2)/ml was aerosolized b y the SPAG-2 aerosol-generator and then introduced into the afferent l oop of the ventilatory circuit. Results: Oxygenation improved dramatic ally and worsened when aerosolization was withdrawn. Intravenous prost acyclin had no additional effect on oxygenation. We observed no side e ffects on blood pressure and no bleeding complications. Inhalation was stopped after 40 hours and the baby was successfully weaned from the ventilator after 108 hours. Conclusion: Inhaled PGI(2) had a beneficia l effect on the oxygenation of a preterm neonate with persistent pulmo nary hypertension of the newborn.