摘要：

Purpose There is a growing interest in the intraoperative and intensive care use of inhaled epoprostenol (PGI 2 ) for the treatment of pulmonary hypertension (PHT) and hypoxia of cardiac or noncardiac origin. We report our experience with this form of therapy. Methods A retrospective chart review of all patients who received inhaled PGI 2 over a one-year period was undertaken. Demographic, hemodynamic, oxygenation status, mode of administration, side effects, duration of hospital stay, and mortality were noted. Results Thirty-five patients, of which 33 (92%) were in the intensive care unit, received inhaled PGI 2 . Of the 27 patients whose pulmonary artery pressure (PAP) was monitored, a significant decrease in mean PAP from 34.8 ± 11.8 mmHgto 32.1 ± 11.8 mmHg was observed within one hour after the start of therapy ( P = 0.0017). Selective pulmonary vasodilatation occurred in 77.8% of the patients. Thirty-three patients had arterial blood gases before and after therapy. There was an improvement in the PaO 2 /FiO 2 ratio in 88% of these with a 175% improvement on average. The ratio of PaO 2 /FiO 2 improved from 108 ± 8 to 138 ± 105 ( P = 0.001). Six patients (17%) presented hypotension, two had subsequent pneumothorax, one had bronchospasm and in one patient PGI 2 inhalation was stopped because of increasing peak pulmonary pressures from the secondary flow coming from the nebulizer. Mortality of the cohort was 54%. Conclusion Inhaled PGI 2 can be useful in the treatment of patients with PHT and severe hypoxia. It can however be associated with systemic side effects.

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