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Chest, Vol 92, 686-691, Copyright © 1987 by American College of Chest Physicians

ARTICLES

Prostaglandin E1 as a screening vasodilator in primary pulmonary hypertension

SM Halpern, PK Shah, S Lehrman, HS Goldberg, AC Jasper and SK Koerner
Division of Pulmonary Medicine, Cedars-Sinai Medical Center, Los Angeles 90048.

Pulmonary vasodilators are variably efficacious in primary pulmonary hypertension (PPH). None has consistently improved hemodynamics enough to obviate the need for complex and potentially hazardous testing of several vasodilators. Prostaglandin E1 (PGE1), a potent, short-acting pulmonary vasodilator, was administered to seven patients with PPH in order to determine whether PGE1 could accurately predict the hemodynamic and gas exchange effects of other commonly used vasodilators. Prostaglandin E1, nifedipine and hydralazine were administered to the patients while measuring pulmonary and systemic hemodynamics and arterial blood gases. Prostaglandin E1 was easily titrated but was inconsistent as a predictor of the effects of the other vasodilators with respect to pulmonary artery pressure, cardiac output and adverse effects on arterial oxygenation. This study suggests that patients with PPH must still receive carefully monitored trials of several vasodilators to determine whether there is a beneficial response and to select the appropriate treatment.




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Copyright © 1987 by the American College of Chest Physicians.