Neonatology Book

Cardiovascular Medicine

  • Prostaglandin E1

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Prostaglandin E1

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  1. Physiology
    1. Onset of effect seen in <30 minutes for cyanotic lesion
    2. Acyanotic lesions may take longer to see effect
  2. Indications
    1. Maintain patency or reopen ductus arteriosus in case of
      1. Cyanotic Congenital Heart Disease
        1. Transposition of the Great Vessels
        2. Tricuspid atresia
      2. Aortic Coarctation
  3. Preparation of infusion
    1. Preparation
      1. Start with "x" mg of Prostaglandin E1
        1. Where "x" = 0.3 x WeightKg
      2. Add enough D5W or NS to Prostaglandin for 50 ml total
    2. At this dilution
      1. Infusion rate of 0.5 ml/min provides 0.05 ug/kg
  4. Dose
    1. Start: Infusion 0.05 - 0.10 ug/kg/min
    2. Cut rate in half until 0.025 ug/kg/min
  5. Precautions
    1. Side effects are common and potentially lethal
      1. Flushing
      2. peripheral edema
      3. Hypotension
      4. Apnea
      5. Hyperpyrexia
      6. Jitteriness
      7. Diarrhea
      8. Hypoglycemia
      9. Hypocalcemia
      10. Renal Failure
      11. Rhythm disturbance
      12. Coagulopathies
    2. Be prepared to intubate before infusing prostaglandin
    3. Keep refrigerated

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