The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

INHALED EPOPROSTENOL IN THE TREATMENT OF PULMONARY ARTERIAL HYPERTENSION

Christina Pano1, Frank Spexarth1, Joe Hegge2; 1Respiratory Therapy, St. Luke’s Medical Center, Milwaukee, WI; 2Carefusion, Lake Villa, IL

Background: Pulmonary Arterial Hypertension (PAH) is commonly associated in patients presenting with heart disease. Post-operative pulmonary hypertension may complicate cardiac failure leading to significant morbidity and mortality. In order to find a cost-effective way to treat PAH, Inhaled Epoprostenol (iEPO) was trialed on patients undergoing valvular heart surgery. Method: The Aeroneb Solo nebulizer was used to continuously deliver iEPO to sixteen patients during cardiac surgery from July 2008 until November 2008. [62.5% female (n=10), mean age 70.4] Patients were administered 40-66 ng/kg/min. of iEPO based on the institution’s orderset. Data was collected to determine if there was a decrease in the systolic pulmonary artery pressures. Results: A decrease in PA pressures was seen in 93.3% of patients placed on iEPO. There was a mean decrease of 27 mmHg in PA pressures. One patient was discounted due to use of IABP and one patient had an increase in 5mmHg when placed on iEPO. There were no side effects noted. The cost of iEPO is an average of $20/hr compared to the cost of Nitric oxide at an average $132/hr. Conclusions: The iEPO showed a great clinical response in patients presenting with PAH. Previous attempts to deliver iEPO have been shown to be more labor intensive and expensive. The Aeroneb delivery system was able to effectively deliver the medication and allow for effective weaning. The medication and delivery mode were tolerated well with no complications. The iEPO has proven to be a cost-effective method of treating PAH in cardiac surgery patients. Sponsored Research - None

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