{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:52Z","timestamp":1756902172300,"version":"3.44.0"},"reference-count":13,"publisher":"The Pediatric Pharmacy Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>This article aims to present our neonatal intensive care unit experience transitioning from intravenous epoprostenol to IV and subcutaneous treprostinil in patients with persistent pulmonary hypertension of the neonate. This was a retrospective chart review at an academic teaching hospital. Neonates with a diagnosis of persistent pulmonary hypertension of the neonate (PPHN) who were started on IV prostacyclin therapy while admitted to the NICU between August 2017 and October 2019 were included. Of the 5 patients included, gestational ages ranged from 24 to 38 weeks. All patients were treated with inhaled nitric oxide and sildenafil before being initiated on IV or SQ prostacyclin therapy. Intravenous epoprostenol dosing was initiated at 1 ng\/kg\/min and was increased by 1 ng\/kg\/min every 12 hours until the provider was satisfied with the clinical response. Once the dose was stable for a few days epoprostenol was transitioned to IV treprostinil using double the last epoprostenol dose. A few days later infants were switched to SQ treprostinil using the same dose by stopping the IV infusion and starting the SQ infusion. All patients survived to hospital discharge and were sent home on SQ treprostinil. Minimal adverse effects were seen; patients experienced some slight hypotension, tachycardia, and diarrhea. Severe pulmonary hypertension is a common occurrence and a significant cause of mortality in the NICU. Our patients demonstrate that IV and SQ prostacyclin therapy is a therapeutic option for PPHN. Additionally, rapid high-dose transition from IV epoprostenol to IV treprostinil and then to SQ treprostinil is well tolerated in neonates, with minimal adverse effects.<\/jats:p>","DOI":"10.5863\/1551-6776-25.7.647","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T23:36:34Z","timestamp":1601422594000},"page":"647-653","source":"Crossref","is-referenced-by-count":1,"title":["Transitioning From Intravenous to Subcutaneous Prostacyclin Therapy in Neonates With Severe Pulmonary Hypertension"],"prefix":"10.5863","volume":"25","author":[{"given":"Meghan N.","family":"Turbenson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Radosevich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinit","family":"Manuel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"2 suppl","key":"i1551-6776-25-7-647-b1","series-title":"Pediatr Crit Care Med","first-page":"S79","article-title":"Neonatal pulmonary hypertension","volume":"11","year":"2010","unstructured":"Steinhorn\n              RH.\n            \n          \n          Neonatal pulmonary hypertension. Pediatr Crit Care Med. 2010;11(2 suppl):S79\u2013S84."},{"issue":"2","key":"i1551-6776-25-7-647-b2","series-title":"Semin Pediatr Surg","first-page":"126","article-title":"Pulmonary hypertension in congenital diaphragmatic hernia","volume":"16","year":"2007","unstructured":"Mohseni-Bod\n              H\n            , BohnD.\n          Pulmonary hypertension in congenital diaphragmatic hernia. Semin Pediatr Surg. 2007;16(2):126\u2013133."},{"issue":"3","key":"i1551-6776-25-7-647-b3","series-title":"Semin Pediatr Surg.","first-page":"147","article-title":"Congenital diaphragmatic hernia-associated pulmonary hypertension","volume":"26","year":"2017","unstructured":"Harting\n              MT.\n            \n          \n          Congenital diaphragmatic hernia-associated pulmonary hypertension. Semin Pediatr Surg.2017;26(3):147\u2013153."},{"issue":"1","key":"i1551-6776-25-7-647-b4","series-title":"Pediatr Allergy Immunol Pulmonol","first-page":"8","article-title":"Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia","volume":"27","year":"2014","unstructured":"Baker\n              CD\n            , AbmanSH, MouraniPM.\n          Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol. 2014;27(1):8\u201316."},{"key":"i1551-6776-25-7-647-b5","series-title":"Paediatr Respir Rev","first-page":"16","article-title":"Pathophysiology, screening and diagnosis of pulmonary hypertension in infants with bronchopulmonary dysplasia--a review of the literature","volume":"23","year":"2017","unstructured":"Altit\n              G\n            , DanceaA, RenaudC, \n          et al. Pathophysiology, screening and diagnosis of pulmonary hypertension in infants with bronchopulmonary dysplasia--a review of the literature. Paediatr Respir Rev. 2017;23:16\u201326."},{"issue":"9","key":"i1551-6776-25-7-647-b6","series-title":"N Engl J Med","first-page":"605","article-title":"Inhaled nitric oxide and persistent pulmonary hypertension of the newborn","volume":"336","year":"1997","unstructured":"Roberts\n              JD\n            , FinemanJR, MorinFC, \n          et al. Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. N Engl J Med. 1997;336(9):605\u2013610."},{"issue":"4","key":"i1551-6776-25-7-647-b7","series-title":"Pediatrics","first-page":"1077","article-title":"Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study","volume":"117","year":"2006","unstructured":"Baquero\n              H\n            , SolizA, NeiraF, \n          et al. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study. Pediatrics. 2006;117(4):1077\u20131083."},{"issue":"3","key":"i1551-6776-25-7-647-b8","series-title":"Semin Perinatol","first-page":"160","article-title":"Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide","volume":"40","year":"2016","unstructured":"Lakshminrusimha\n              S\n            , MathewB, LeachCL.\n          Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide. Semin Perinatol. 2016;40(3):160\u2013173."},{"issue":"4","key":"i1551-6776-25-7-647-b9","series-title":"Pulm Circ","first-page":"862","article-title":"Safety of epoprostenol and treprostinil in children less than 12 months of age","volume":"3","year":"2013","unstructured":"McIntyre\n              CM\n            , HannaBD, RintoulN, \n          et al. Safety of epoprostenol and treprostinil in children less than 12 months of age. Pulm Circ. 2013;3(4):862\u2013869."},{"year":"2012","series-title":"Epoprostenol [package insert]","key":"i1551-6776-25-7-647-b10","unstructured":"Epoprostenol [package insert]. San Francisco, CA: Actelion Pharmaceuticals Inc; 2012."},{"year":"2011","series-title":"Treprostinil [package insert]","key":"i1551-6776-25-7-647-b11","unstructured":"Treprostinil [package insert]. Research Triangle Park, NC: United Therapeutics Corp; 2011."},{"issue":"12","key":"i1551-6776-25-7-647-b12","series-title":"Am J Resp Crit Care Med","first-page":"1586","article-title":"Transition from intravenous epoprostenol to intravenous treprostinil in pulmonary hypertension","volume":"172","year":"2005","unstructured":"Gomberg-Maitland\n              M\n            , TapsonVF, BenzaRL, \n          et al. Transition from intravenous epoprostenol to intravenous treprostinil in pulmonary hypertension. Am J Resp Crit Care Med. 2005;172(12):1586\u20131589."},{"issue":"1","key":"i1551-6776-25-7-647-b13","series-title":"J Cardiovasc Pharmacol","first-page":"1","article-title":"Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension","volume":"49","year":"2007","unstructured":"Sitbon\n              O\n            , ManesA, JaisX, \n          et al. Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension. J Cardiovasc Pharmacol. 2007;49(1):1\u20135."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/25\/7\/article-p647.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/25\/7\/647\/2606064\/1551-6776-25_7_647.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/25\/7\/article-p647.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/25\/7\/article-p647.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:39:04Z","timestamp":1747355944000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/25\/7\/article-p647.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":13,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-25.7.647","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}