Inhaled iloprost is used as a therapeutic option in pulmonary hypertension especially in adults. However, there have been only few reports on the use of this drug for neonate and infant. We would like to report the use of iloprost in treating pulmonary hypertension of a infant. Inhaled iloprost reduced pulmonary hypertension and improved oxygenation without decreasing systemic blood pressure.
A 5mo-old male infant visited premature baby clinic with breathing difficulty and chest retraction. He was immediately transferred to intensive care unit.
This infant was born in 26 wks gestation, with 800 gm birth weight, via Caesarean section and received neonatal intensive care unit for 4 months due to respiratory distress syndrome and prematurity and had bronchopulmonary dysplasia.
Chest radiography showed severe cardiomegaly. Echocardiograpy showed severe pulmonary hypertension. Initial treatments included respiratory support with high frequency oscillatory ventilation (HFOV) and sildenafil. On the 3rd hospital day, the clinical condition did not much improve and HFOV was disconnected.
NO was not available. Inhaled iloprost with sildenafil was used. Iloprost was used through aerosolizing circuit and nebulizer for about 20 days. He was disconnected from oxygen and improvement in oxygen was achieved and continued to improve. After 23 days, he was discharged with normal oxygen saturation in room air.
Our experience indicates that iloprost could be a promising therapy for pulmonary hypertension, especially, in case of NO unavailability. Future studies are warranted to better define safety and effect of iloprost in comparison with other available vasodilator drugs.