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01-08-2011 | Short Report

Combination therapy for life-threatening pulmonary hypertension in a premature infant: first report on bosentan use

Authors: Maurizio Radicioni, Alessia Bruni, Piergiorgio Camerini

Published in: European Journal of Pediatrics | Issue 8/2011

Abstract

Premature infants with preterm premature rupture of membranes (PPROM) are at high risk of severe respiratory failure because of lung hypodysplasia associated with persistent pulmonary hypertension of the newborn (PPHN). We describe the clinical course of a 28-week gestation infant with PPROM from the 20th week and prolonged oligohydramnios before delivery, who developed refractory hypoxia treated with oral bosentan as adjunct therapy to inhaled nitric oxide (iNO) and oral sildenafil. Conclusion Our experience suggests that bosentan can be used in the premature infant with PPHN after PPROM. To the best of our knowledge, this is the first report of bosentan treatment in a premature infant.

Aikio O, Saarela T, Pokela ML, Hallman M (2003) Nitric oxide treatment and acute pulmonary inflammatory response in very premature infants with intractable respiratory failure shortly after birth. Acta Paediatr 92:65–69PubMedCrossRef

Apostolopoulou SC, Manginas A, Cokkinos DV, Rammos S (2007) Long-term oral bosentan treatment in patients with pulmonary arterial hypertension related to congenital heart disease: a 2-year study. Heart 93:350–354PubMedCrossRef

Barrington KJ, Finer NN. Inhaled nitric oxide for respiratory failure in preterm infants (2010) Cochrane Database Syst Rev 12. CD000509. doi:10.1002/14651858.CD000509.pub4

Cavallaro G, Agazzani E, Andaloro L, Bottura C, Cristofori G, Mussini P, Sacco F, Compagnoni G (2008) Sildenafil and nitric oxide inhalation in neonatal pulmonary hypertension. Three case reports. Pediatr Med Chir 30:149–155PubMed

Figueras-Aloy J, Gómez-Lopez L, Rodríguéz-Miguélez JM, Jordán-García Y, Salvia-Roiges MD, Jiménez W, Carbonell-Estrany X (2004) Plasma endothelin-1 and clinical manifestations of neonatal sepsis. J Perinat Med 32:522–526PubMedCrossRef

Filan PM, McDougall PN, Shekerdemian LS (2006) Combination pharmacotherapy for severe neonatal pulmonary hypertension. J Paediatr Child Health 42:219–220PubMedCrossRef

Geary C, Whitsett J (2002) Inhaled nitric oxide for oligohydramnios-induced pulmonary hypoplasia: a report of two cases and review of the literature. J Perinatol 22:82–85PubMedCrossRef

Goissen C, Ghyselen L, Tourneux P, Krim G, Storme L, Bou P, Maingourd Y (2008) Persistent pulmonary hypertension of the newborn with transposition of the great arteries: successful treatment with bosentan. Eur J Pediatr 167:437–440PubMedCrossRef

Ivy DD, Ziegler JW, Dubus MF, Fox JJ, Kinsella JP, Abman SH (1996) Chronic intrauterine pulmonary hypertension alters endothelin receptor activity in the ovine fetal lung. Pediatr Res 39:435–442PubMedCrossRef

10.

Kilbride HW, Thibeault DW (2002) Strategies of cardiovascular and ventilatory management in preterm infants with prolonged rupture of fetal membranes and oligohydramnios. J Perinatol 22:510PubMedCrossRef

11.

Kiowski W, Sütsch G, Hunziker P, Müller P, Kim J-H, Oechslin E, Schmitt R, Jones R, Bertel O (1995) Evidence for endothelin-1 mediated vasoconstriction in severe chronic heart failure. Lancet 346:732–736PubMedCrossRef

12.

Kumar VH, Hutchison AA, Lakshminrusimha S, Morin FC III, Wynn RJ, Ryan RM (2007) Characteristics of pulmonary hypertension in preterm neonates. J Perinatol 27:214–219PubMed

13.

Marsh CS, Marden B, Newsom R (2004) Severe retinopathy of prematurity (ROP) in a premature baby treated with sildenafil acetate (Viagra) for pulmonary hypertension. Br J Ophthalmol 88:306–307PubMedCrossRef

14.

Nakwan N, Choksuchat D, Saksawad R, Thammachote P, Nakwan N (2009) Successful treatment of persistent pulmonary hypertension of the newborn with bosentan. Acta Paediatr 98:1683–1685PubMedCrossRef

15.

Pak O, Aldashev A, Welsh D, Peacock A (2007) The effects of hypoxia on the cells of the pulmonary vasculature. Eur Respir J 30:364–372PubMedCrossRef

16.

Pellowski A, Finer N, Etches P, Tierney A, Ryan A (1995) Inhaled nitric oxide for premature infants after prolonged rupture of the membranes. J Pediatr 126:450–453CrossRef

17.

Shah PS, Ohlsson A (2007) Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev 3. CD005494. doi:10.1002/14651858.CD005494.pub2

18.

Skinner JR, Boys RJ, Heads A, Hey EN, Hunter S (1996) Estimation of pulmonary arterial pressure in the newborn: study of the repeatability of four Doppler echocardiographic techniques. Pediatr Cardiol 17:360–369PubMedCrossRef

19.

Storme L, Rakza T, Houfflin-Debarge V, Dufour P, Bouissou A, Subtil D, Deruelle P (2007) Consequences of premature rupture of the membranes in the perinatal lung. Arch Pediatr 14:S42–S48PubMedCrossRef

20.

Sütsch G, Kiowski W, Yan X-W, Hunziker P, Christen S, Strobel W, Kim J-H, Rickenbacher P, Bertel O (1998) Short-term oral endothelin receptor antagonist therapy in conventionally treated patients with symptomatic severe chronic heart failure. Circulation 98:2262–2268PubMed

21.

Thibeault D, Kilbride H (1997) Increased acinar arterial wall muscle in preterm infants with PROM and pulmonary hypoplasia. Am J Perinatol 14:457–460PubMedCrossRef

22.

Truog WE, Pallotto E, Clark P, Banks B, Kaftan HA, Ekekezie II, Norberg M, Ballard RA (2002) Interaction of endogenous endothelin-1 and inhaled nitric oxide in term and preterm infants. Clin Sci 103:294S–297SPubMed

23.

Williams O, Hutchings G, Debieve F, Debauche C (2009) Contemporary neonatal outcome following rupture of membranes prior to 25 weeks with prolonged oligohydramnios. Early Hum Dev 85:273–277PubMedCrossRef

Title: Combination therapy for life-threatening pulmonary hypertension in a premature infant: first report on bosentan use
Authors: Maurizio Radicioni
Alessia Bruni
Piergiorgio Camerini
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: European Journal of Pediatrics / Issue 8/2011
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-011-1422-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Combination therapy for life-threatening pulmonary hypertension in a premature infant: first report on bosentan use

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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