Prostaglandin E[1] treatment in patent ductus arteriosus dependent congenital heart defects

Abstract

Prostaglandin E₁ (PGE₁) treatment can be life saving in patients suffering from ductus dependent congenital heart defect. We analyzed the indications and side-effects of PGE₁ therapy over a five-year period. The purpose of the study was also to examine whether a change in serum electrolyte levels could be detected.

Forty-nine patients were treated with PGE₁ during this period. PGE₁ treatment was indicated by ductus dependent systemic circulation in 16 cases, ductus dependent pulmonary circulation in 17 cases, transposition of the great arteries in 13 cases and pulmonary hypertension (persistent fetal circulation) in three cases.

As early side-effects of the treatment, fever occurred in 27/49 cases while apnoea was observed in 15 patients. In a one-week-old neonate with coarctation of the aorta grade III intraventricular hemorrhage developed. A mild decrease of sodium, potassium and chloride levels and a slight shift of pH levels toward metabolic alkalosis could be detected after one day and one week of PGE₁ treatment.

Because of these side-effects of PGE₁ patients should be monitored in an intensive care unit. According to our observations electrolyte levels may exhibit a slight decrease; however, in the case of a short-term therapy extra salt supplementation is not necessary.