Uso de Prostaglandina E1 en cardiopatías congénitas ductus-dependientes

Abstract

Introduction: Ductus-dependent congenital heart defects are those defects that require ductal patency to maintain systemic or pulmonary circulation, and therefore require the use of prostaglandin E1 (PGE1).Objectives: To describe the efficacy and safety of PGE1 in ductus-dependent congenital heart and its implications for airway management. Materials and Methods: We conducted a retrospective observational study of patients with ductus-dependent congenital heart disease who received PGE1 while hospitalized between January 2009 and December 2013 in the cardiovascular intensive care unit of the Hospital de Clínicas, School of Medical Science, National University of Asuncion, Paraguay. Results: We assessed 44 patients (average age: 9 days) most of whom were full-term newborns with appropriate birthweights. The most common heart defects were transposition of the great arteries, pulmonary atresia, and hypoplastic left heart syndrome. Initial and maintenance doses averaged 0.045 µ/Kg/min and mean duration of infusion was 5.5 days. Side effects were present in 56% of patients, primarily apnea (38%) and fever. Apnea was an indicator for mechanically assisted ventilation in 31% of patients. PGE1 was effective in 95% of patients. Mortality was 10%. Conclusions: PGE1 is effective in the management of ductus-dependent congenital heart, while apnea is the most common side effect and requires mechanically assisted ventilation, probably due to the doses usually used.