Chest
Selected ReportsAerosolized Iloprost Therapy Could Not Replace Long-term IV Epoprostenol (Prostacyclin) Administration in Severe Pulmonary Hypertension
Section snippets
Materials and Methods
The three patients were women, 42, 30, and 49 years old; thefirst two patients had PPH and the third patient suffered fromprogressive pulmonary hypertension after occlusion of an atrialseptal defect.2 All had been treated withcontinuous IV epoprostenol and warfarin for 4 years, which had improvedtheir New York Heart Association functional class from III and IV to, II. All three patients had experienced episodes of life-threateningsepsis caused by the catheter (Port-A-Cath; SIMS Deltec; St.
Discussion
Weaning from long-term treatment with continuous IV epoprostenolunder repeated inhalations of aerosolized iloprost was not successfulin the three patients with severe pulmonary hypertension. In patient 1,IV epoprostenol could only be reduced from 13 to 6 ng/kg/min, becauseat this dosage the patient developed acute right heart failure. Inpatient 2, termination of epoprostenol was immediately followed byright heart failure. In patient 3, weaning from epoprostenol seemed tobe successful; however,
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