Side-effects of long-term prostaglandin E sub(1) treatment in neonates

• Published in: Pediatrics international 2007-06, Vol.49 (3), p.335-340
• Main Authors: TALOSI, GYULA, Katona, Marta, Turi, Sandor
• Format: Article
• Language: English
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/j.1442-200X.2007.02380.x

BackgroundIn some neonates suffering from ductus arteriosus dependent congenital heart defect, a Prostaglandin E sub(1) (PGE1) therapy longer than 2 weeks may be needed. However, PGE1 analogue compounds may produce several adverse effects. MethodsThe authors retrospectively analyzed the data of nine patients who underwent a PGE1 treatment lasting longer than 14 days. ResultsThe leukocyte count of the patients remained high throughout the treatment period, and the proportion of neutrophils was over 50%. Transient feeding difficulty and abdominal distension, and possible signs of gastric-outlet obstruction, were observed in two cases. In the case of three patients, cortical hyperostosis developed after different cumulative doses (1584, 3384 and 4320 mu g/kg). Significant correlations were found between the doses of PGE1 and serum K super(+) levels (r=-0.770, P < 0.05) and between the blood standard bicarbonate levels and PGE1 doses (r= 0.889, P < 0.01). Bartter syndrome-like condition developed in those three patients who received the largest cumulative doses. ConclusionsFluid-electrolyte parameters must be controlled frequently in the case of each patient treated with PGE1 for longer than 2 weeks. Although the dose, the length of the therapy and individual susceptibility may be equally important, fluid-electrolyte disturbances and the development of pseudo-Bartter syndrome seem to be more dose-dependent than cortical hyperostosis.