Evaluation of the Prostaglandin Therapy in Newborns with Duct Dependent Congenital Heart Defects
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Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Prostaglandīnu E1 lieto jaundzimušajiem ar kritiskām iedzimtām sirdskaitēm, lai saglabātu
funkcionējošu arteriālo vadu līdz brīdim, kad veic paliatīvu vai koriģējošu operāciju. Standarta
Prostaglandīna E1 sākumdeva ir 50 ng/kg minūtē, šī ieteicamā deva nav mainīta kopš
medikamenta pielietošanas uzsākšanas 1981. gadā. Joprojām nav vienota pieeja un pietiekama
izpēte mazas devas pielietošanā, tādēļ ir būtiski izvērtēt mazas devas priekšrocības un
efektivitāti.
Šī literatūras apskata mērķis ir analizēt un sniegt pašreizējās zināšanas par pierādījumiem, kas
liecina par optimālo PGE1 terapijas devu un ilgumu, lai saglabātu arteriālā vada funkcionēšanu,
novērtēt terapijas blakusparādības un efektivitāti, novērtēt medikamenta pielietošanas ilgumu
un tā ietekmi uz blaknēm un efektivitāti.
Metodes: Tika veikta literatūras avotu meklēšana, izmantojot PRIMO un PubMed. Pārskatot
literatūru, izmantojot atlases kritērijus kā atbilstoši tika analizēti seši pētījumi, izmantotas 26
atsauces.
Mērķis: Noteikt un pārskatīt pašreizējās zināšanas par to, kādi ir klīniskie pierādījumi par
optimālo PGE1 terapijas devu un ilgumu arteriālā vada funkcionēšanas nodrošināšanai, par
blakusparādībām un terapijas efektivitāti. Kā arī noskaidrot, vai pastāv atšķirības PGE1
terapijas nevēlamo blakusparādību un efektivitātes ziņā kopš 1981. gada līdz mūsdienām.
Secinājumi: Analizētie pētījumi ir veikti dažādās pētījumu grupās, taču ir ievērojams skaits
norāžu, ka efektivitāte un blakusparādības ir vairāku faktoru atkarīgas. Tādi faktori kā deva ,tās
ilgums, priekšlaicīgas dzemdības, elpošanas stāvoklis var ietekmēt efektivitāti un
blakusparādības. Šajā zinātnisko rakstu pārskatā nav pierādījumu par ārstēšanas ilguma
izmaiņām kopš 1981. gada.
Prostaglandin E1 is used in neonates with critical congenital heart disease in order to maintain ductal patency until palliative or corrective surgery can be performed. The standard starting dose of prostaglandin E1 is 50 ng/kg/minute, this dose recommendation has not been changed since the treatment firstly was introduced in 1981. Lower doses are frequently used in clinics with successful results. However, the efficacy and safety of a lower dose routine has not yet been established and is a relevant topic for investigation. This literature review aims to analyse and present current knowledge of evidence for an optimal dosage and duration in PGE1 therapy in maintaining the patency of ductus arteriosus, considering the adverse effects and effectiveness of the therapy. Furthermore, the treatment development over time and its duration is reviewed. Method: An advanced search was performed using PRIMO and PubMed. When reding the literature additional references was found in the reference list and added to the reviews. Six studies were reviewed, 26 different references were included in total. Aim: To determine and review the current knowledge of what is the greatest clinical evidence for an optimal dosage and duration in PGE1 therapy in maintaining the patency of ductus arteriosus, regarding adverse effects and effectiveness of the therapy. As well, to find out if there are differences in adverse effects and effectiveness of the treatment of PGE1 since 1981 until today. Conclusion: The investigated studies are performed in different cohorts, still there are a significant number of indications that the efficiency and adverse effects are multifactorial. Dose, duration, prematurity, respiratory status is pointed out to be some of the factors influencing the efficiency and adverse effects. In this review no evidence or conclusion about the change in treatment duration since 1981 can be concluded.
Prostaglandin E1 is used in neonates with critical congenital heart disease in order to maintain ductal patency until palliative or corrective surgery can be performed. The standard starting dose of prostaglandin E1 is 50 ng/kg/minute, this dose recommendation has not been changed since the treatment firstly was introduced in 1981. Lower doses are frequently used in clinics with successful results. However, the efficacy and safety of a lower dose routine has not yet been established and is a relevant topic for investigation. This literature review aims to analyse and present current knowledge of evidence for an optimal dosage and duration in PGE1 therapy in maintaining the patency of ductus arteriosus, considering the adverse effects and effectiveness of the therapy. Furthermore, the treatment development over time and its duration is reviewed. Method: An advanced search was performed using PRIMO and PubMed. When reding the literature additional references was found in the reference list and added to the reviews. Six studies were reviewed, 26 different references were included in total. Aim: To determine and review the current knowledge of what is the greatest clinical evidence for an optimal dosage and duration in PGE1 therapy in maintaining the patency of ductus arteriosus, regarding adverse effects and effectiveness of the therapy. As well, to find out if there are differences in adverse effects and effectiveness of the treatment of PGE1 since 1981 until today. Conclusion: The investigated studies are performed in different cohorts, still there are a significant number of indications that the efficiency and adverse effects are multifactorial. Dose, duration, prematurity, respiratory status is pointed out to be some of the factors influencing the efficiency and adverse effects. In this review no evidence or conclusion about the change in treatment duration since 1981 can be concluded.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Prostaglandīns E1;Iedzimtas sirdkaites; Atvērts arteriālais vads., Prostaglandin E1; PGE1; Congenital Heart Disease; arteriosus patency; Adverse Effects.