Kritik hasta pediatrik hastalarda intravenöz iloprost kullanımının değerlendirilmesi: tek merkez deneyimi

Year 2025, Volume: 8 Issue: 2, 249 - 253, 21.03.2025

Merve Mısırlıoğlu , Mehmet Alakaya , Ali Ertuğ Arslanköylü , Abdulkadir Bilgiç

https://doi.org/10.32322/jhsm.1576395

Abstract

Amaçlar: İloprost, sistemik düzeyde vazodilatasyon özelliklerine sahip, trombosit agregasyonunu ve adezyonunu inhibe eden ve anjiyogenezi tetikleyen bir prostasiklin analoğudur. Pediatrik yoğun bakım ünitelerinde vazodilatör olarak iloprostun intravenöz (IV) uygulanmasıyla ilgili deneyimimiz sınırlıdır. Bu çalışmada IV iloprost tedavisine tabi tutulan hastaların özellikleri ve tedaviye yanıtları araştırılmaktadır.
Yöntemler: 15 aylık bir dönemde IV iloprost tedavisi alan tüm hastalar çalışmaya dahil edildi. Yaş, cinsiyet, hastaneye yatış nedeni, vasküler hasar nedeni, etkilenen damar, iloprost dozu, tedavi süresi, cerrahi gerekliliği ve tedaviyle ilişkili komplikasyonların oluşumu gibi veriler retrospektif hasta dosyalarından elde edildi.
Bulgular: Çalışma sırasında IV iloprost tedavisi alan on hasta incelendi. Tüm hastalarda ilacın başlangıç ​​dozu 0,5 ng/kg/dk idi ve başlangıç ​​dozuna yedi hastada devam edildi. İloprost kullanım süresi 17,8±10,8 (min 1, maks 28) gündü. Hastaneye yatış nedenlerinin %50'si (n=5) travmatik olmayan nedenlerdi. Üç hastaya (%30) ampütasyon uygulandı. Ekstremite hasarı olanların klinik sınıflandırmasında, evre 1'de dört hasta (%44,5), evre IIa'da iki hasta (%22,2) ve evre IIb'de üç hasta (%33,3) vardı. Evre IIb'de üç hastaya ampütasyon uygulandı ve bu, dozun 0,5 ng/kg/dk dozuyla başlandığı ve dozun artırıldığı hasta grubudur.
Sonuç: İntravenöz iloprost tedavisi, vasküler yaralanma durumlarında hipoksi ve doku hücre hasarını önlemede faydalı, minimal yan etkiye sahip güvenli bir tedavi seçeneğidir.

Keywords

Çocuk, iloprost, pediatrik yoğun bakım, vazodilatasyon

Evaluation of intravenous iloprost use in critically ill pediatric patients: single center experience

Abstract

Aims: Iloprost is a prostacyclin analog that has vasodilatation properties at the systemic level, inhibiting platelet aggregation and adhesion and triggering angiogenesis. Our experience with intravenous (IV) administration of iloprost as a vasodilator in pediatric intensive care units is limited. The present study investigates the characteristics of patients subjected to IV iloprost therapy and their response to treatment.
Methods: A 15-month period, all patients who received IV iloprost treatment were included. Data including age, gender, reason for hospitalization, cause of vascular damage, affected vessel, iloprost dosage, treatment duration, necessity of surgery, and occurrence of treatment-related complications were retrieved from retrospective patient files.
Results: During the study, IV ten patients receiving iloprost treatment were examined. The starting dose of the drug was 0.5 ng/kg/min in all patients, and the initial dose was continued in seven patients. Duration of iloprost use was 17.8±10.8 (min 1, max 28) days. 50% (n=5) of the reasons for hospitalization were non-traumatic reasons. Amputation was performed in three patients (30%). In the clinical classification of those with damage to the extremities, there were four patients in stage 1 (44.5%), two patients in stage IIa (22.2%), and three patients in stage IIb (33.3%). Amputation was applied to three patients in stage IIb, and this is the patient group where the dose was started at a dose of 0.5 ng/kg/min and the dose was increased.
Conclusion: Intravenous iloprost treatment is a safe therapeutic option with minimal side effects, beneficial for preventing hypoxia and tissue cellular damage in cases of vascular injury.

Keywords

Child, iloprost, pediatric intensive care, vasodilation

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