The use of prostaglandin E1 and Blalock-Taussig shunts in neonates with cyanotic congenital heart disease. |
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Authors: | D A Browdie W Norberg R Agnew B Altenburg R Ignacio C Hamilton |
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Affiliation: | From the Departments of Cardiothoracic Surgery, Pediatrics, and Anesthesiology, Fargo Clinic and St. Luke''s Hospital, Fargo, and the University of North Dakota School of Medicine, Grand Forks, ND |
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Abstract: | Six unselected neonates with cyanotic congenital heart disease and life-threatening degrees of arterial oxygen desaturation have been managed by a protocol that includes administration of prostaglandin E1 (PGE1) and early Blalock-Taussig shunting. In 5 patients (seven paired observations) partial pressure of arterial oxygen (PaO2) rose from 19 mm Hg to a mean of 32.9 mm Hg within 20 minutes of initiation of PGE1 (0.1 to 0.2 microgram/kg/hr), infused intravenously or through an aortic catheter placed at ductal level or with both methods. The nonresponsive patient was older than the patients showing a positive response (1 month versus 24 to 96 hours). Following catheterization, immediate palliative operation including a Blalock-Taussig shunt was carried out. Although all had a satisfactory PaO2 (mean, 49 mm Hg) postoperatively, the PGE1-nonresponsive patient experienced serious intraoperative bradycardia, hypotension, and acidosis in contrast to the PGE1-responsive group. In this study, the use of PGE1 was not associated with any apparent serious side effects. |
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Keywords: | Address reprint requests to Dr. Browdie Fargo Clinic 737 Broadway Box 2067 Fargo ND 58102 |
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