阿普前列地尔治疗导管通畅的效果

Q2 Medicine Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-01-01 Epub Date: 2024-02-07 DOI:10.5863/1551-6776-29.1.37
Caitlin M Gordon, Jason T Tan, Roxane R Carr
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引用次数: 0

摘要

研究目的:本研究旨在描述低初始阿普司他地尔剂量对维持导管依赖性先天性心脏病(DDCHD)婴儿动脉导管通畅(PDA)的有效性。次要目标是描述任何药物不良事件、描述处方趋势、描述动脉导管直径的变化以及比较极低和较低阿普司他地初始剂量方案的安全性和有效性:这项回顾性观察队列研究在不列颠哥伦比亚省妇女儿童医院新生儿重症监护室和儿科重症监护室进行,研究对象是接受阿普司他地尔治疗以保持动脉导管通畅的二度缺血缺氧新生儿。研究了超低剂量阿普司他地(小于 0.01 微克/千克/分钟)与低剂量阿普司他地(等于或大于 0.01 微克/千克/分钟)的对比情况。疗效的定义是存活率和不需要复苏事件(心脏骤停、心源性休克、蓝色代码、体外生命支持、紧急心脏手术需求和呼吸性酸中毒)的婴儿。纳兰霍评分达到或超过 3 分的药物不良反应也包括在内:阿前列地尔对88%的患者有效,超低剂量组和低剂量组之间无差异。在纳入的 75 名患者中,有 25 人接受了超低剂量的阿前列地尔治疗。药物不良反应很常见(51%),低剂量组新生儿比超低剂量组新生儿出现更多呼吸暂停和热病:结论:阿前列地尔疗法能有效维持DDCHD新生儿的PDA,且剂量较小。两种剂量方案的药物不良反应都很常见;但超低剂量组的呼吸暂停和脓毒症似乎较少。
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Effectiveness of Alprostadil for Ductal Patency.

Objectives: This study aims to describe the effectiveness of low initial alprostadil dosages to maintain a patent ductus arteriosus (PDA) in infants with ductal-dependent congenital heart disease (DDCHD). Secondary objectives were to describe any adverse drug events, describe prescribing trends, describe ductus arteriosus diameter changes, and compare the safety and efficacy of very low and low initial alprostadil dosage regimens.

Methods: This retrospective observational cohort study at the British Columbia's Women's and Children's Hospital neonatal intensive care unit and pediatric intensive care unit examined neonates admitted with DDCHD who received alprostadil to maintain ductal patency. Very low-dose alprostadil (less than 0.01 mcg/kg/min) versus low-dose alprostadil (equal to or greater than 0.01 mcg/kg/min) was examined. Effectiveness was defined as survival and infants not requiring a resuscitation event (cardiac arrest, cardiogenic shock, code blue, extracorporeal life support, requirement for emergent cardiac surgery, and respiratory acidosis). Adverse drug events with a Naranjo score of 3 or more were included.

Results: Alprostadil was effective for 88% of patients, with no difference between the very low-dose and low-dose groups. Of the 75 patients included, 25 received very low-dose alprostadil. Adverse drug events were common (51%) with neonates in the low-dose group experiencing more apnea and pyrexia than neonates in the very low-dose group.

Conclusions: Alprostadil therapy was effective in maintaining the PDA in neonates with DDCHD with low-dosage regimens. Adverse drug events were common with both dosage regimens; however, the very low dosage appeared to have less apnea and pyrexia.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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