{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:37:37Z","timestamp":1774330657411,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":17,"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":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inhaled epoprostenol (iEpo) may improve oxygenation in adults with hypoxic respiratory failure, but any effect in children with pediatric acute respiratory distress syndrome (pARDS) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective observational cohort study 2017\u20132022 at a single pediatric intensive care unit (PICU) of children who met criteria for pARDS and received iEpo for \u2265\u20096\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      18 children were included, with a median age of 2.9 years (IQR 1.4\u20137.9), severe pARDS in 14\/18 (78%), and pulmonary hypertension in 8\/18 (44%). Median OSI immediately pre\u2010iEpo initiation was 22.9 (IQR 16.1\u201327.3), at 6\u2009h was 16.8 (IQR 12.6\u201327.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.57 vs. pre\u2010initiation) and at 12\u2009h was 15.1 (IQR 10.7\u201327.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.48 vs. pre\u2010initiation). Discontinuity regression demonstrated a change in the slope (rate of change) of OSI from increasing slope of +0.60\/hr to decreasing slope of \u22121.38\/hour in the 12\u2009h pre\u2010 versus post\u2010 iEpo initiation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 6\u2009h after iEpo initiation, most patients (12\/18, 67%) had a decrease in OSI and 5\/18 (28%) were responders with a decrease of \u2265\u200920%. Responders did not differ significantly by presence of pulmonary hypertension, severity of pARDS, or age. The majority of responders (4\/5, 80%) had improvement in OSI by 1\u2009h after initiation of iEpo and all (5\/5, 100%) had improvement by 4\u2009h after iEpo initiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rate of change of OSI improved significantly after initiation of iEpo in a cohort children with pARDS, with heterogeneity of response that was not associated with pHTN or other clinical factors evaluated. Improvement in OSI was seen by 4\u2009h in all responders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71010","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T05:41:16Z","timestamp":1739857276000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Inhaled Epoprostenol in Children With Pediatric Acute Respiratory Distress Syndrome: A Single\u2010Center Retrospective Study"],"prefix":"10.1002","volume":"60","author":[{"given":"Eleanor J.","family":"Scalone","sequence":"first","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan G.","family":"Woodruff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Anesthesiology Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit K.","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Neurology Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristopher L.","family":"Dixon","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andora L.","family":"Bass","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Anesthesiology Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-750X","authenticated-orcid":false,"given":"Michael C.","family":"McCrory","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Anesthesiology Wake Forest University School of Medicine Winston\u2010Salem North Carolina 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