Analysis of the Factors That Influence on the Effect of Prostaglandin E1(PGE₁)in Infants with Ductus-Dependent Cyanotic Congenital Heart Disease

Background

The prostaglandin E₁(PGE₁) is a well known protent dilator of arteriosus. Maintaining of the patency of ductus arteriosus is crucial for the survival of patients suffering from ductus-dependent cyanotic congenital heart disease. We aimed to analyse the efficacy and the influencing factors upon PGE1 in patients suffering from this disease.

Methods

Between May 1991 and April 1993, 26 neonates and infants with ductus- dependent cyanotic congenital heart disease received on intravenous infusion of PGE1 in the Division of Pediatric Cardiology. Yonsei Cardiovascular Center. The result was a dramatic improvement in systemic arterial oxygen tension and oxygen saturation during infusion of PGE₁with a dependency on the infusion of PGE₁. We evaluated the arterial blood gas analysis both at the immediate pre-infusion stage and 2 hours after infusion. We aimed to analyse the factors which may influence the intravenous of PGE₁to infant suffers of ducts-dependent cyanotic congenital heart disease. such as pulmonary atresia(n=14), severe pulmonary stenosis(n=7) or complete transposition of the great arteries(n=5).

Results

1) There was a significant increase in PaO₂and Oxygen saturation 2 hours after the infusion of PGE₁. This appeared to be unrelated to the different forms of the disease when compared with the pre-infusion values.

2) The infants' responsiveness of the ductus arteriosus appeared to be age related with significant differences emerging between the 2 group(p<.05). In infants younger than 9 hours old, the differences in PaO₂changes between pre-infusion and post-infusion of PGE₁were 16.3±3.7mmHg compared to just 10.4±0.4mmHg in infants older than 96 hours.

3) No significant difference emerged between an increase in PaO₂or oxygen saturation relating to the shape of ductus arteriosus ; or the level of PaO₂prior to the infusion 4) The side effects of PGE₁were as follows ; fever(84.6%),loose stool(61.5%), apnea(30.8%) and hypotension(15.4%), etc..

Conclusion

PGE₁provides excellent medical palliation for infants suffering from ductus-dependent cyanotic congenital heart disease until the pulmonary arteries are large enough for a modified Blalock-Taussig shunt ; or until corrective surgery is possible.