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Pediatric Cardiology

, Volume 37, Issue 2, pp 338–344 | Cite as

Prostaglandin Availability and Association with Outcomes for Infants with Congenital Heart Disease

  • Brady S. Moffett
  • Joshua M. Garrison
  • Aimee Hang
  • Shaine A. Morris
  • Rocky Tsang
  • Kimberly Dinh
  • Pamela Griffiths
  • Ronald Bronicki
  • Paul A. ChecchiaEmail author
Original Article

Abstract

Data regarding availability of prostaglandin E1 (PGE) and its impact on the stabilization, transport, critical care course, and surgical outcome of infants with ductal-dependent congenital heart disease in the current pediatric healthcare environment are unknown. We sought to determine the proportion of hospitals in Texas that stock PGE and to investigate associations between PGE availability and clinical outcomes. All birth institutions listed with the Texas Department of Health and Human Services were contacted to determine PGE availability as of 2011. Outcomes of all infants admitted to our institution from 2007 to 2012 who received PGE for ductal-dependent lesions were evaluated. PGE was stocked in 50 % (n = 139) of hospitals that performed deliveries in Texas in 2011 representing 79.1 % (303, 481) of births. Hospitals that did not stock PGE had less annual births and were located a further distance from a center that provided pediatric cardiac surgical services. Patients born at a hospital that did not stock PGE had significantly greater serum lactate and creatinine (p = 0.002) and serum lactate on admission (p < 0.001). The PGE availability was not associated with hospital length of stay, postoperative length of stay, or mortality. When stratifying in TGA and HLHS subgroups, lack of PGE availability remained associated with higher creatinine, higher lactate, lower glucose, and lower pH. PGE is not universally available in all healthcare institutions providing obstetrical services. Lack of availability of PGE at an outlying hospital was associated with increased morbidity, but was not associated with mortality or length of stay.

Keywords

Prostaglandin Patent ductus arteriosus Cardiac surgery Pediatric 

Abbreviations

PGE

Prostaglandin E1

CHD

Congenital heart disease

Notes

Author Contributions

Brady S. Moffett conceptualized and designed the study, drafted the manuscript, and had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis and approved the final manuscript as submitted. Paul A. Checchia conceptualized and designed the study, drafted the manuscript, and had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis and approved the final manuscript as submitted. Shaine A. Morris was responsible for statistical analysis, interpretation of data, and critical revision of the manuscript for important intellectual content and approved the final manuscript as submitted. Pamela Griffiths and Ronald Bronicki were responsible for analysis, interpretation of data, and critical revision of the manuscript for important intellectual content and approved the final manuscript as submitted. Joshua M. Garrison, Aimee Hang, Rocky Tsang, and Kimberly Dinh were responsible for acquisition, analysis, interpretation of data, and critical revision of the manuscript for important intellectual content and approved the final manuscript as submitted.

Financial Disclosure

Authors Brady S. Moffett, Joshua M. Garrison, Aimee Hang, Shaine A. Morris, Rocky Tsang, Kimberly Dinh, Pamela Griffiths, Ronald Bronicki, and Paul A. Checchia have no financial relationships to disclose that are relevant to this study.

Compliance with Ethical Standards

Conflict of interest

All authors have completed and submitted the ICMJE form for Disclosure of Potential Conflicts of Interest. No authors report any conflicts of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Brady S. Moffett
    • 1
  • Joshua M. Garrison
    • 1
    • 2
  • Aimee Hang
    • 1
    • 2
  • Shaine A. Morris
    • 3
  • Rocky Tsang
    • 4
  • Kimberly Dinh
    • 1
  • Pamela Griffiths
    • 5
  • Ronald Bronicki
    • 4
  • Paul A. Checchia
    • 4
    Email author
  1. 1.Department of PharmacyTexas Children’s HospitalHoustonUSA
  2. 2.College of PharmacyUniversity of HoustonHoustonUSA
  3. 3.The Section of Cardiology, Department of PediatricsTexas Children’s Hospital and the Baylor College of MedicineHoustonUSA
  4. 4.The Sections of Critical Care Medicine and Cardiology, Department of PediatricsTexas Children’s Hospital and the Baylor College of MedicineHoustonUSA
  5. 5.The Section of Newborn Medicine, Department of PediatricsTexas Children’s Hospital and the Baylor College of MedicineHoustonUSA

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