Prostaglandin E₂ administration in infants with ductus-dependent cyanotic congenital heart disease

Abstract

Prostaglandin E₂ was administered to 22 newborns with ductus-dependent cyanotic congenital heart disease. Twelve patients had pulmonary atresia and ten simple dextrotransposition of the great arteries. Patients were classified into two groups: group 1 (n=11) received prostaglandin E₂ by the intravenous route (dose: 0.01–0.05 μg/kg per min); group 2 (n=11) received prostaglandin E₂ by the oral route (dose: 35–65 μg/kg per 1–4 h). Treatment lasted for 1–90 days. All infants except one of group 2 showed a significant (>10 Torr) increase in PaO₂ following PGE₂ administration. The mean increase in PaO₂ was higher (P<0.01) in group 1 (21.8±1.7, Torr) than in group 2 (15.8±1.5, Torr). PaO₂ fell significantly (P<0.01) in five patients of group 1 who continued treatment orally with satisfactory (>30 Torr) levels in four of them. Severe side effects were observed only in group 1. The data show that similarly to prostaglandin E₁ infusions, prostaglandin E₂, given i.v. or orally, is useful in the management of infants with ductus-dependent cyanotic congenital heart disease. Oral prostaglandin E₂, administration is less effective than i.v. infusions, but can be used for long-term, therapy being more convenient and causing minimal morbidity.