Aerosolized iloprost in the treatment of pulmonary hypertension in extremely preterm infants: a pilot study

Klin Padiatr. 2008 Mar-Apr;220(2):66-9. doi: 10.1055/s-2007-984370. Epub 2007 Aug 21.


Background: In premature infants with preterm prolonged rupture of membranes, death after birth is often due to persistent pulmonary hyper-tension.

Patients: Aerosolized iloprost was used to treat pulmonary hypertension due to prolonged preterm rupture of fetal membranes (7-56 days) in four extremely low-birthweight neonates (23-25 weeks' gestation, weight 448-645 g) under spontaneous breathing supported by nasal continuous positive airway pressure.

Method: Inhalation dose was 2 microg/kg b.w. and between 44 and 65 inhalations were performed in each patient starting within the first hour of life over a total of several days. Single inhalations lasted 5 min and were not repeated until 60 min had elapsed.

Results: After the first inhalation, the PaO2/FiO2 mean ratio increased from 65 (range 35-114) to 194 (148-250) mmHg and oxygenation requirements decreased within the next 7 days. Echocardiography similarly showed reduction in pulmonary resistance. We observed no severe side effects on blood pressure or prolonged bleeding time during inhalation.

Conclusions: Iloprost inhalation might therefore be an additional treatment for improving oxygenation in cases of persistent pulmonary hypertension in extremely low-birthweight infants under spontaneous breathing. Further randomized clinical studies are required to establish the role of iloprost in this setting.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aerosols
  • Age Factors
  • Continuous Positive Airway Pressure*
  • Critical Illness
  • Echocardiography
  • Female
  • Fetal Membranes, Premature Rupture
  • Gestational Age
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / drug therapy
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / therapy*
  • Iloprost / administration & dosage*
  • Infant, Extremely Low Birth Weight
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy*
  • Male
  • Pilot Projects
  • Pregnancy
  • Respiratory Therapy
  • Time Factors
  • Vasodilator Agents / administration & dosage*


  • Aerosols
  • Vasodilator Agents
  • Iloprost