Prostaciclina nebulizada como tratamiento de la hipertensión pulmonar primaria en una niña de 2 años
Nebulized prostacyclin treatment for pulmonary hypertension in a 2-year-old girl
Unitat Integrada Hospital Sant Joan de Déu-Hospital Clínic. Servicio de Pediatría. Sección de Cardiología. Universidad de Barcelona. Esplugues de Llobregat. Barcelona
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González López, A. del Pino de la Fuente, F.J. García Martín, F. Calbo Torrecillas, I. Obando Santaella, J. Campos, A. Martínez Valverde" "autores" => array:7 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "González López" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "del Pino de la Fuente" ] 2 => array:2 [ "nombre" => "F.J." "apellidos" => "García Martín" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Calbo Torrecillas" ] 4 => array:2 [ "nombre" => "I." "apellidos" => "Obando Santaella" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Campos" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Martínez Valverde" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774819?idApp=UINPBA00005H" "url" => "/16954033/0000005300000004/v1_201307051520/S1695403300774819/v1_201307051520/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Prostaciclina nebulizada como tratamiento de la hipertensión pulmonar primaria en una niña de 2 años" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "372" "paginaFinal" => "376" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Puigarnau Vallhonrat, M. Pons Ódena, E. Carballo Ruano" "autores" => array:3 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Puigarnau Vallhonrat" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Pons Ódena" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Carballo Ruano" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unitat Integrada Hospital Sant Joan de Déu-Hospital Clínic. Servicio de Pediatría. Sección de Cardiología. Universidad de Barcelona. Esplugues de Llobregat. Barcelona" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Servicio de Pediatría. Hospital Sant Joan de Déu. Passeig Sant Joan de Déu, 2. Esplugues de Llobregat. Barcelona" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nebulized prostacyclin treatment for pulmonary hypertension in a 2-year-old girl" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-11-30" "fechaAceptado" => "2000-06-30" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186448" "palabras" => array:8 [ 0 => "Hipertensión pulmonar primaria" 1 => "Niños" 2 => "Prostaciclina nebulizada" 3 => "Prostaciclina infusión continua" 4 => "Primary pulmonary hypertension" 5 => "Children" 6 => "Nebulized prostacyclin" 7 => "Continuous intravenous prostacyclin" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La hipertensión pulmonar primaria es una entidad de origen desconocido e infrecuente en la edad pediátrica. Se define como un aumento de la presión media de la arteria pulmonar superior a 25 mmHg en reposo con presión de enclavamiento normal y ausencia de causas secundarias. En el tratamiento se usan los diuréticos, bloqueadores del canal del calcio y, en los pacientes que no responden, prostaciclina endovenosa continua. Presentamos una paciente tratada con prostaciclina nebulizada objetivándose una mejoría clínica durante 4 meses</p> <span class="elsevierStyleSectionTitle">Observación clínica</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Niña de 2 años de edad ingresada por presentar fallo cardíaco derecho que se estabiliza con oxigenoterapia, restricción de líquidos y diuréticos. La paciente es diagnosticada de hipertensión pulmonar primaria tras excluirse las etiologías secundarias. Se realiza cateterismo cardíaco confirmatorio del diagnóstico, sin respuesta positive al test de vasodilatación. Dado el deterioro clínico se inicia tratamiento con prostaciclina nebulizada. Se observa una mejoría clínica y una disminución de las necesidades de oxígeno y diuréticos durante 4 meses. Tras este período presenta un empeoramiento clínico, por lo que se decide instaurar tratamiento con PGI2 endovenosa continua. La paciente fallece a los 6 meses del diagnóstico por fallo cardíaco</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El uso de prostaciclina en el manejo de la hipertensión pulmonar primaria es una alternativa aceptada en aquellos pacientes que no responden al tratamiento habitual. La mejoría transitoria en la calidad de vida y las necesidades de oxígeno en nuestra paciente apoya el uso de prostaciclina nebulizada como opción útil en pacientes pediátricos.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Primary pulmonary hypertension is an unusual disease of unknown aetiology in childhood. It is defined as a mean pulmonary artery pressure greater than 25 mmHg at rest with normal wedge pulmonary pressure and absence of secondary causes. Treatment is based on diuretics and calcium-channel blockers and, in non-responders, on continuous intravenous prostacyclin. We report the case of a patient who was treated with nebulized prostacyclin who showed clinical improvement for 3 months</p> <span class="elsevierStyleSectionTitle">Case report</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A 2-year-old child with right heart failure was admitted and stabilized with oxygen, restriction of liquids, and diuretics. The patient was diagnosed with primary pulmonary hypertension after exclusion of secondary causes. Cardiac catheterization confirmed the diagnosis. Pulmonary vascular reactivity did not test positive. Because of clinical deterioration, treatment with nebulized prostacyclin was started. We observed clinical improvement with a decrease in oxygen and diuretics demand for 3 months. After this period, the patient deteriorated and continuous intravenous prostacyclin was started. The patient died of heart failure 6 months after diagnosis</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The use of prostacyclin in the management of primary pulmonary hypertension is an alternative in non-responding patients. Clinical improvement and decrease in oxygen demand support the use of nebulized prostacyclin as a useful approach in pediatric patients</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of prostacyclin in the treatment of primary pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Cremona" 1 => "T. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 10 | 14 |
| 2024 Octubre | 49 | 51 | 100 |
| 2024 Septiembre | 42 | 62 | 104 |
| 2024 Agosto | 40 | 87 | 127 |
| 2024 Julio | 49 | 48 | 97 |
| 2024 Junio | 54 | 64 | 118 |
| 2024 Mayo | 39 | 44 | 83 |
| 2024 Abril | 41 | 51 | 92 |
| 2024 Marzo | 46 | 52 | 98 |
| 2024 Febrero | 43 | 57 | 100 |
| 2024 Enero | 54 | 65 | 119 |
| 2023 Diciembre | 65 | 48 | 113 |
| 2023 Noviembre | 42 | 42 | 84 |
| 2023 Octubre | 35 | 50 | 85 |
| 2023 Septiembre | 23 | 36 | 59 |
| 2023 Agosto | 29 | 44 | 73 |
| 2023 Julio | 36 | 64 | 100 |
| 2023 Junio | 22 | 61 | 83 |
| 2023 Mayo | 49 | 41 | 90 |
| 2023 Abril | 32 | 21 | 53 |
| 2023 Marzo | 29 | 41 | 70 |
| 2023 Febrero | 24 | 31 | 55 |
| 2023 Enero | 31 | 41 | 72 |
| 2022 Diciembre | 37 | 55 | 92 |
| 2022 Noviembre | 46 | 63 | 109 |
| 2022 Octubre | 46 | 49 | 95 |
| 2022 Septiembre | 23 | 31 | 54 |
| 2022 Agosto | 42 | 46 | 88 |
| 2022 Julio | 36 | 47 | 83 |
| 2022 Junio | 34 | 40 | 74 |
| 2022 Mayo | 31 | 45 | 76 |
| 2022 Abril | 34 | 41 | 75 |
| 2022 Marzo | 47 | 63 | 110 |
| 2022 Febrero | 45 | 46 | 91 |
| 2022 Enero | 43 | 43 | 86 |
| 2021 Diciembre | 33 | 49 | 82 |
| 2021 Noviembre | 45 | 48 | 93 |
| 2021 Octubre | 98 | 55 | 153 |
| 2021 Septiembre | 40 | 40 | 80 |
| 2021 Agosto | 29 | 28 | 57 |
| 2021 Julio | 40 | 35 | 75 |
| 2021 Junio | 40 | 49 | 89 |
| 2021 Mayo | 36 | 34 | 70 |
| 2021 Abril | 74 | 95 | 169 |
| 2021 Marzo | 79 | 47 | 126 |
| 2021 Febrero | 82 | 23 | 105 |
| 2021 Enero | 79 | 23 | 102 |
| 2020 Diciembre | 96 | 18 | 114 |
| 2020 Noviembre | 84 | 12 | 96 |
| 2020 Octubre | 53 | 13 | 66 |
| 2020 Septiembre | 109 | 12 | 121 |
| 2020 Agosto | 70 | 8 | 78 |
| 2020 Julio | 45 | 21 | 66 |
| 2020 Junio | 43 | 13 | 56 |
| 2020 Mayo | 34 | 16 | 50 |
| 2020 Abril | 20 | 12 | 32 |
| 2020 Marzo | 16 | 13 | 29 |
| 2020 Febrero | 19 | 17 | 36 |
| 2020 Enero | 29 | 18 | 47 |
| 2019 Diciembre | 51 | 14 | 65 |
| 2019 Noviembre | 26 | 19 | 45 |
| 2019 Octubre | 44 | 12 | 56 |
| 2019 Septiembre | 33 | 19 | 52 |
| 2019 Agosto | 28 | 9 | 37 |
| 2019 Julio | 33 | 42 | 75 |
| 2019 Junio | 23 | 35 | 58 |
| 2019 Mayo | 28 | 35 | 63 |
| 2019 Abril | 31 | 29 | 60 |
| 2019 Marzo | 8 | 11 | 19 |
| 2019 Febrero | 18 | 14 | 32 |
| 2019 Enero | 12 | 14 | 26 |
| 2018 Diciembre | 11 | 8 | 19 |
| 2018 Noviembre | 18 | 17 | 35 |
| 2018 Octubre | 34 | 11 | 45 |
| 2018 Septiembre | 14 | 5 | 19 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Mayo | 3 | 0 | 3 |
| 2018 Abril | 5 | 0 | 5 |
| 2018 Marzo | 17 | 0 | 17 |
| 2018 Febrero | 6 | 0 | 6 |
| 2018 Enero | 26 | 0 | 26 |
| 2017 Diciembre | 22 | 0 | 22 |
| 2017 Noviembre | 9 | 0 | 9 |
| 2017 Octubre | 8 | 0 | 8 |
| 2017 Septiembre | 14 | 0 | 14 |
| 2017 Agosto | 7 | 0 | 7 |
| 2017 Julio | 9 | 0 | 9 |
| 2017 Junio | 15 | 8 | 23 |
| 2017 Mayo | 17 | 14 | 31 |
| 2017 Abril | 10 | 5 | 15 |
| 2017 Marzo | 19 | 14 | 33 |
| 2017 Febrero | 9 | 10 | 19 |
| 2017 Enero | 4 | 1 | 5 |
| 2016 Diciembre | 10 | 8 | 18 |
| 2016 Noviembre | 23 | 7 | 30 |
| 2016 Octubre | 29 | 8 | 37 |
| 2016 Septiembre | 32 | 4 | 36 |
| 2016 Agosto | 14 | 6 | 20 |
| 2016 Julio | 12 | 4 | 16 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Marzo | 1 | 0 | 1 |
| 2016 Febrero | 3 | 0 | 3 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Noviembre | 1 | 0 | 1 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Agosto | 2 | 0 | 2 |
| 2015 Julio | 7 | 0 | 7 |
| 2015 Junio | 5 | 0 | 5 |
| 2015 Mayo | 16 | 6 | 22 |
| 2015 Abril | 12 | 9 | 21 |
| 2015 Marzo | 10 | 0 | 10 |
| 2015 Febrero | 9 | 0 | 9 |
| 2015 Enero | 20 | 0 | 20 |
| 2014 Diciembre | 9 | 1 | 10 |
| 2014 Noviembre | 13 | 0 | 13 |
| 2014 Octubre | 10 | 1 | 11 |
| 2014 Septiembre | 16 | 3 | 19 |
| 2014 Agosto | 13 | 2 | 15 |
| 2014 Julio | 10 | 2 | 12 |
| 2014 Junio | 26 | 1 | 27 |
| 2014 Mayo | 23 | 3 | 26 |
| 2014 Abril | 18 | 3 | 21 |
| 2014 Marzo | 22 | 5 | 27 |
| 2014 Febrero | 13 | 7 | 20 |
| 2014 Enero | 13 | 9 | 22 |
| 2013 Diciembre | 21 | 13 | 34 |
| 2013 Noviembre | 16 | 5 | 21 |
| 2013 Octubre | 19 | 7 | 26 |
| 2013 Septiembre | 21 | 8 | 29 |
| 2013 Agosto | 15 | 6 | 21 |
| 2013 Julio | 5 | 2 | 7 |
| 2013 Junio | 2 | 2 | 4 |
| 2013 Mayo | 1 | 3 | 4 |
| 2013 Abril | 1 | 1 | 2 |
| 2013 Marzo | 5 | 2 | 7 |
| 2013 Febrero | 18 | 5 | 23 |
| 2013 Enero | 18 | 1 | 19 |
| 2012 Diciembre | 10 | 2 | 12 |
| 2012 Noviembre | 12 | 2 | 14 |
| 2012 Octubre | 13 | 1 | 14 |
| 2012 Septiembre | 2 | 1 | 3 |
| 2000 Septiembre | 757 | 0 | 757 |
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