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Short term effect of intravenous treprostinil in term and preterm infants with pulmonary hypertension

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Authors

Kim, Yoo-Jin; Shin, Seung Han; Kim, Ee-Kyung; Kim, Han-Suk

Issue Date
2024-01-29
Publisher
BMC
Citation
BMC Pediatrics, Vol.24, no.83
Keywords
Pulmonary hypertensionTerm infantPreterm infantPulmonary vasodilator agentProstacyclin analogue
Abstract
Background
Pulmonary hypertension (PH) is a life-threatening condition in newborns. We aimed to assess the clinical and echocardiographic responses of term and preterm infants to treprostinil.

Methods
This retrospective study included newborns diagnosed with PH and treated with treprostinil as additional therapy after inhaled nitric oxide administration in the neonatal intensive care unit of a tertiary center. Term and preterm infants were compared in terms of echocardiographic findings and clinical findings 4 weeks after treprostinil treatment.

Results
During the study period, 11 term and 18 preterm infants were diagnosed with PH and received treprostinil. There were no differences in the echocardiographic findings of interventricular septal deviation, direction of shunt, and ratio of estimated pulmonary artery pressure over systolic blood pressure. Congenital diaphragmatic hernia was the most common condition occurring upon PH diagnosis among term infants, while severe bronchopulmonary dysplasia was the most common in preterm infants. Improvements in echocardiographic findings were more pronounced in term infants than in preterm infants (100% vs. 55.6%, P = 0.012). The inhaled nitric oxide dose was gradually tapered for term infants and was lower than that for preterm infants at 1, 2, and 3 weeks after treprostinil.

Conclusion
Intravenous treprostinil could be an adjuvant therapy option for term and preterm infants with PH, especially for those who cannot receive oral medication. The efficacy and safety of treprostinil in this population with PH should be investigated further.
ISSN
1471-2431
Language
English
URI
https://hdl.handle.net/10371/198979
DOI
https://doi.org/10.1186/s12887-023-04501-4
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