Inhaled iloprost is an effective alternative therapy for persistent
pulmonary hypertension of the newborn
Abstract
Purpose: Persistent pulmonary hypertension of the newborn
(PPHN) is a disease with potential serious morbidity and mortality.
Inhaled iloprost, a stable analogue of prostacyclin, has recently been
used as a therapeutic option. However, there are no clinical guidelines
on the use of iloprost, specifically for neonates. This study aimed to
suggest the use of inhaled iloprost as a rescue therapy for PPHN based
on our experience. Methods: This was a retrospective study. The
data from medical records of 6 newborns (3 late preterm, 3 term),
diagnosed as persistent pulmonary hypertension of the newborn and had
received inhaled iloprost from December 2019 to April 2022 were
collected. Demographic and clinical features, dosing regimen, changes in
oxygenation index, echocardiographic findings and mortality were
evaluated. Results: The inhalation dose was 2-4 mcg/dose, and
3-48 inhalations per day were applied over 2-7 days. Inhaled iloprost
was effective in all patients. No side effects attributable to inhaled
iloprost and no mortality was recorded. Conclusion: Our
experience suggests that inhaled iloprost can be used as a firstĀ-line
therapy in newborn infants with PPHN when inhaled nitric oxide is not
available, although there are large fluctuations in oxygenation index
due to setting.