Effect of aerosolized PGE1 on the ductus arteriosus of neonatal swine

Background: Inhaled PGE(1) (IPGE(1)) is a potential pulmonary vasodilator in neonatal respiratory failure. However, its effect on the patency of the ductus arteriosus (DA) has not been described. Objective: To investigate the effect of IPGE(1) on the DA in healthy piglets. Design/methods: IPGE(1) (1200 ng/kg/min) [Study] or nebulized saline [Control] was administered using a jet nebulizer. Transthoracic echocardiography (TTE) was performed prior to (TO) and after 24 h of aerosol therapy (T24). The DA was also evaluated histomorphologicaily at autopsy. Results: Fifteen piglets, 1-9 days old (study = 9: control = 6), were evaluated for DA patency. Study piglets received IPCE1 for 12-24 h. TTE was performed on 12 piglets at T0. Nine animals showed no ductal now and 3 (1 study, 2 control) had a small DA. TTE at T24 in 5 animals showed no change in DA. At autopsy, the ductal diameter and histologic maturity stage were comparable in study and control animals. Conclusions: High dose IPGE(1) given for 12-24 h does not exert significant effect on the DA of healthy term piglets as evaluated by echocardiography and histomorphology. We conclude that ductal patency in neonates is influenced not only by prostaglandins but also by factors like hypoxemia, prematurity, and heart disease. (C) 2009 Elsevier Inc. All rights reserved