{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T21:28:13Z","timestamp":1774474093042,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T00:00:00Z","timestamp":1583712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prostanoid treatment in patients with severe pulmonary arterial hypertension (PAH) has been proven safe and effective. Subcutaneous administration of treprostinil has side effects, which limits their use and acceptance. An implantable pump for continuous intravenous treprostinil infusion has been recently approved. We describe our experience with the implantable pump in three pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Description of Cases<\/jats:title><jats:p>The LENUS pro pump was implanted in three adolescents with severe PAH, who were treated with tadalafil, ambrisentan, and subcutaneous treprostinil. The indication of the Lenus pro pump implantation was the local side effects of subcutaneous treprostinil (pain, inflammation, and local infection) that were not well tolerated and that severely decreased their quality of life. The pump was surgically implanted under general anesthesia.One patient, in functional class IV, suffered postoperative hemodynamic instability and small pneumothorax, \u2009requiring an increase in treprostinil dose up to 85\u2009ng\/kg\/min and a decrease 9 days after the pump implantation. The second patient who was discharged 4 days after surgery with treprostinil at 60\u2009ng\/kg\/min reported improvement in his quality of life, but the dose requirement increased up to 92\u2009ng\/kg\/min. After a 21\u2010month follow\u2010up, this patient received a lung transplant. The third patient presented a hematoma at the pump site with no other complications and had a follow\u2010up of 9 months with an improvement in her quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Comments<\/jats:title><jats:p>Implantable pumps for continuous parenteral prostanoid infusion in pediatric patients are an alternative to external pumps, especially when familiar psychological or psychomotor issues hinder the use of external pumps.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24707","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T09:55:55Z","timestamp":1583747755000},"page":"1254-1258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Implantable LENUS pro pump for treprostinil infusion in three pediatric patients"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2130-7880","authenticated-orcid":false,"given":"Maria","family":"\u00c1lvarez\u2010Fuente","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Garrido\u2010Lestache","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-7090","authenticated-orcid":false,"given":"Natalia","family":"Rivero","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasa","family":"Centella","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J.","family":"Lamas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"P\u00e9rez\u2010Caballero","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose L.","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J.","family":"Del Cerro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Ramon y Cajal Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01916-2018"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.09.119"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.09.025"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.03.067"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.096412"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045893218754886"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-017-1114-1"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0474-7"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.06.006"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894018788846"}],"container-title":["Pediatric 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