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Circulatory Effects of Inhaled Iloprost in the Newborn Preterm Lamb.

Noponen, Tommi ; Nord, Anders LU ; Berg, Ansgar LU ; Ley, David LU ; Hansson, Stefan LU orcid ; Pesonen, Erkki LU and Fellman, Vineta LU orcid (2009) In Pediatric Research 66. p.416-422
Abstract
Inhaled nitric oxide (iNO) has an established role in the treatment of pulmonary hypertension in the newborn. However, costs and potential toxicity associated with iNO have generated interest in alternative inhaled selective pulmonary vasodilators such as iloprost. In a preterm lamb model of respiratory distress syndrome, we studied effects of increasing doses of iloprost followed by iNO on right ventricular pressure (RVP) and circulation including cerebral oxygenation. Fetal sheep were randomized to three doses (0.2 - 4 mg/kg) of iloprost (n=9) or saline (n=10), administered as 15 min inhalations with 15 min intervals after a 60-min postnatal stabilisation. No differences were found in RVP, arterial pO2, or cardiac index according to... (More)
Inhaled nitric oxide (iNO) has an established role in the treatment of pulmonary hypertension in the newborn. However, costs and potential toxicity associated with iNO have generated interest in alternative inhaled selective pulmonary vasodilators such as iloprost. In a preterm lamb model of respiratory distress syndrome, we studied effects of increasing doses of iloprost followed by iNO on right ventricular pressure (RVP) and circulation including cerebral oxygenation. Fetal sheep were randomized to three doses (0.2 - 4 mg/kg) of iloprost (n=9) or saline (n=10), administered as 15 min inhalations with 15 min intervals after a 60-min postnatal stabilisation. No differences were found in RVP, arterial pO2, or cardiac index according to treatment. The cerebral oxygenation, measured with near-infrared spectroscopy, deteriorated in control lambs, but not in iloprost lambs. Iloprost treatment followed by iNO resulted in a larger decrease (p=0.007) in RVP than saline treatment followed by iNO. In conclusion, iloprost stabilised cerebral oxygenation and when followed by iNO had a larger effect on RVP than iNO alone. Although species differences may be relevant, these results suggest that iloprost should be studied in newborn infants for the treatment of pulmonary hypertension. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pediatric Research
volume
66
pages
416 - 422
publisher
International Pediatric Foundation Inc.
external identifiers
  • wos:000270285400012
  • pmid:19581832
  • scopus:70350437805
  • pmid:19581832
ISSN
1530-0447
DOI
10.1203/PDR.0b013e3181b3b2a4
language
English
LU publication?
yes
id
37924ed5-a2da-40b7-8daf-1fd4a6d62ae9 (old id 1453363)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19581832?dopt=Abstract
date added to LUP
2016-04-04 08:54:07
date last changed
2022-01-29 07:28:07
@article{37924ed5-a2da-40b7-8daf-1fd4a6d62ae9,
  abstract     = {{Inhaled nitric oxide (iNO) has an established role in the treatment of pulmonary hypertension in the newborn. However, costs and potential toxicity associated with iNO have generated interest in alternative inhaled selective pulmonary vasodilators such as iloprost. In a preterm lamb model of respiratory distress syndrome, we studied effects of increasing doses of iloprost followed by iNO on right ventricular pressure (RVP) and circulation including cerebral oxygenation. Fetal sheep were randomized to three doses (0.2 - 4 mg/kg) of iloprost (n=9) or saline (n=10), administered as 15 min inhalations with 15 min intervals after a 60-min postnatal stabilisation. No differences were found in RVP, arterial pO2, or cardiac index according to treatment. The cerebral oxygenation, measured with near-infrared spectroscopy, deteriorated in control lambs, but not in iloprost lambs. Iloprost treatment followed by iNO resulted in a larger decrease (p=0.007) in RVP than saline treatment followed by iNO. In conclusion, iloprost stabilised cerebral oxygenation and when followed by iNO had a larger effect on RVP than iNO alone. Although species differences may be relevant, these results suggest that iloprost should be studied in newborn infants for the treatment of pulmonary hypertension.}},
  author       = {{Noponen, Tommi and Nord, Anders and Berg, Ansgar and Ley, David and Hansson, Stefan and Pesonen, Erkki and Fellman, Vineta}},
  issn         = {{1530-0447}},
  language     = {{eng}},
  pages        = {{416--422}},
  publisher    = {{International Pediatric Foundation Inc.}},
  series       = {{Pediatric Research}},
  title        = {{Circulatory Effects of Inhaled Iloprost in the Newborn Preterm Lamb.}},
  url          = {{http://dx.doi.org/10.1203/PDR.0b013e3181b3b2a4}},
  doi          = {{10.1203/PDR.0b013e3181b3b2a4}},
  volume       = {{66}},
  year         = {{2009}},
}