Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease

Abstract

This study reports our experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD). PGE1 efficacy, side-effects as well as the cardiovascular and respiratory profile of the patients were analysed. PGE1 doses > 0.02 microgram/kg per minute were used for only 5.3% of the total 23,656 h of treatment. The mean systolic blood pressures did not differ from the normal mean for patients with cyanotic CHD, while the diastolic values were lowered. Respiratory support was required only during 13.7% of the total treatment time. Apnoeas occurred in 21 (38%) of the 55 spontaneously breathing infants, who all had a cyanotic CHD. The incidence of apnoeas was lower during treatment with doses < 0.01 microgram/kg per minute.

Conclusion: PGE1 can be successfully administered in lower doses than previously recommended. Especially high initial doses can be avoided and low maintenance doses allow long-term treatment without serious complications.