Iloprost instillation in two neonates with pulmonary hypertension

Pulmonary hypertension may coexist with certain diseases in neonates. Iloprost inhalation is one of the treatments which cause selective pulmonary vasodilatation. Inhalation is not an easy way of drug administration in mechanically ventilated infants; as some exhibit desaturations during inhalation. Moreover, inhalation of drug requires cessation of mechanical ventilation, if patient is on high frequency oscillatory ventilation. We presented two patients with pulmonary hypertension; term baby with congenital diaphragmatic hernia and preterm baby with respiratory distress syndrome; who had iloprost instillation during mechanical ventilation treatment. Iloprost instillation was well tolerated with no side effects in the term patient with diaphragmatic hernia; whereas severe blood pressure fluctuations were observed in the preterm infant. This report may courage administration of iloprost in term neonates with resistant pulmonary hypertension

effects of surfactant on oxygenation in term infants with respiratory failure

The objective of the study was to evaluate the effects of exogenous surfactant on respiratory indices in term infants with respiratory failure. Consecutive 18 mechanically ventilated term infants, who received a single dose of exogenous surfactant were retrospectively included into the study. The respiratory outcome of surfactant rescue therapy was evaluated by comparing respiratory indices before and six hours after surfactant administration. Median oxygenation index [OI], mean alveolar pressure [MAP] and fraction of inspired oxygen [FiO[2]] values were significantly decreased [P<0.001]; median arterial oxygen partial pressure [PaO[2]], arterial oxygen saturation [SaO[2]] and PaO[2]/FiO[2] values were significantly increased six hours after surfactant treatment [P<0.001]. Rescue therapy with surfactant was found to be effective in the improvement of early respiratory indices in term infants with respiratory failure