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Use of prostacyclin in pulmonary hypertension

Introduction

The use of drugs such as epoprostenol which dilate the pulmonary vessels is indicated in patients with primary pulmonary hypertension in order to improve their clinical status before being transplanted.

We describe our experience in six patients with primary pulmonary hypertension who received prostacyclin and underwent lung transplantation sometime later.

Material and methods

Six patients aged between 19 and 50 years old (2 female, 4 male). Base diagnosis was primary pulmonary hypertension. In all of them a haemodynamic study with Swan-Ganz catheter was performed. Patients were treated initially with acenocumarol and diltiazem. If they presented auricular fibrilation or low right ventricular function, digoxin was associated. If the end telediastolic right ventricular pressure was increased, dicumarinic was associated. If the right ventricular function became worse, prostacyclin was added to the treatment.

Results

Dose of prostacyclin: 4–6 ng/kg per min

Time of waiting before lung transplantation: 25 days to 6 months

Clinical improvement of right ventricular function: 5 patients

Dysnea after moderate efforts: 3 patients

Improvement of pulmonary artery pressure: 6 patients

Conclusions

Prostacyclin is an usefull treatment of pulmonary hypertension to improve the clinical status and the haemodynamic parameters in these patients and it helps until lung transplantation can be performed.

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Vicente, R., López, L., Ramos, F. et al. Use of prostacyclin in pulmonary hypertension. Crit Care 2, P118 (1998). https://doi.org/10.1186/cc247

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Keywords

  • Pulmonary Artery
  • Digoxin
  • Pulmonary Hypertension
  • Ventricular Function
  • Diltiazem