Implantable LENUS pro pump for treprostinil infusion in three pediatric patients

Pediatric Pulmonology
Maria Álvarez-FuenteMaria J Del Cerro

Abstract

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. 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,  requiring an increase in treprostinil dose up to 85 ng/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 ng/kg/min reported improvement in his quality of life, but the dose requirement increased up to 92 ng/kg/min...Continue Reading

References

Oct 27, 2006·Heart·Astrid E LammersSheila G Haworth
Nov 3, 2010·The Journal of Pediatrics·Marilyne LevyDamien Bonnet
Apr 22, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Ralf EwertHossein-Ardeschir Ghofrani
Oct 9, 2018·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Manuel J RichterRalf Ewert
Dec 14, 2018·The European Respiratory Journal·Erika B RosenzweigRolf M F Berger

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Citations

Oct 2, 2020·Pediatric Pulmonology·Charissa W Kam, Fadel E Ruiz

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