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Nitroglycerin inhalation for acute treatment of pulmonary arterial hypertension in children with congenital heart disease

Part of: Interventional Cardiology

Published online by Cambridge University Press:  04 June 2021

Eva Miranda Marwali Open the ORCID record for Eva Miranda Marwali [Opens in a new window] ,
Muhammad Rayhan  and
Poppy S. Roebiono
Eva Miranda Marwali*
Affiliation:
Pediatric Cardiac Intensive Care Division, National Cardiovascular, Center, Harapan Kita, Jakarta, Indonesia
Muhammad Rayhan
Affiliation:
Pediatric Cardiac Intensive Care Division, National Cardiovascular, Center, Harapan Kita, Jakarta, Indonesia
Poppy S. Roebiono
Affiliation:
Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
*
Author for correspondence: Eva Miranda Marwali, MD, PhD, Pediatric Cardiac ICU Division, National Cardiovascular Center Harapan Kita Jl. Let. Jend. S. Parman, Kav 87, Slipi, West Jakarta, 11420, Indonesia. Mobile: (+62)813 8570 2548; Work: (62)21 5684085 ext. 2807; Fax: +62 21 5684230. E-mail: [email protected]
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Abstract

Objectives:

Acute pulmonary hypertension and pulmonary hypertensive crisis may result in adverse clinical outcomes if unsuccessfully treated. Inhaled nitric oxide has long been considered as the standard pharmacotherapy for acute pulmonary hypertension, but lack of feasibility in some settings and evidences challenging its benefits lead to the use of alternative treatment, amongst which is nitroglycerin inhalation. The purpose of this review article is to discuss available data on the use of nitroglycerin inhalation for acute treatment of pulmonary hypertension in children with CHD and its potential benefit in post-operative setting.

Data sources:

Literatures included in this review were acquired by searching in PubMed online database. Keywords used were “Pulmonary Hypertension”, “Congenital heart defects”, “Pediatrics”, “Inhaled nitroglycerin”, and its synonyms.

Study selection:

Title and abstract were screened to select relevant literatures including the three paediatric clinical trials on nitroglycerin inhalation. Critical appraisal of the clinical trials was then done using the University of Oxford Centre of Evidence-Based Medicine Critical Appraisal Tools.

Conclusions:

Paediatric studies showed the benefit of nitroglycerin inhalation in uncorrected cases of CHD during catheterisation procedures. Until recently, there have been no studies conducted in paediatric post-operative CHD cases. Further study is required to provide evidence for inhaled nitroglycerin use in this setting including the appropriate dosing and potential side effects with repeated administration,

Keywords

Nitroglycerin inhalationaerosolised nitroglycerinexogenous nitric oxidepulmonary arterial hypertensioncongenital heart diseasecorrective surgery
Type
Review
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1381 - 1385
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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