Prostaglandin E1 and survival in patients with the adult respiratory distress syndrome. A prospective trial

Ann Surg. 1986 Apr;203(4):371-8. doi: 10.1097/00000658-198604000-00006.


A 7-day infusion of prostaglandin E1 (PGE1), an immunomodulator, was evaluated in a prospective, randomized, placebo-controlled, double-blinded trial in surgical patients with the adult respiratory distress syndrome (ARDS). The drug seemed to improve pulmonary function--only two PGE1 patients died with severe pulmonary failure compared with nine placebo patients (p = 0.01). Survival at 30 days after the end of the infusion--the predetermined end point of the study--was significantly better in the patients given PGE1 (p = 0.03), with 15 of 21 PGE1 patients (71%) alive at this time compared with seven of 20 placebo patients (35%). Improvement in overall survival in the PGE1 patients did not reach statistical significance (p = 0.08). Overall survival in patients initially free of severe organ failure, however, was significantly better in the PGE1 patients (p = 0.03). Of the six PGE1 patients free of severe organ failure at time of entry, all survived to leave the hospital; of the 10 placebo patients initially free of severe organ failure, four survived. The drug had no serious side effects and did not potentiate susceptibility to infection. PGE1 is a promising agent for the treatment of ARDS.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alprostadil / administration & dosage
  • Alprostadil / adverse effects
  • Alprostadil / therapeutic use*
  • Clinical Trials as Topic
  • Double-Blind Method
  • Female
  • Humans
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Prospective Studies
  • Random Allocation
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / mortality


  • Alprostadil