The use of prostaglandin E₁ in a critically ill infant with transposition of the great arteries

Continuous prostaglandin E₁ infusion temporarily maintains patency of the ductus arteriosus in infants for periods ranging from a few hours to several days. This can be lifesaving in neonatal patients awaiting surgical palliation for the type of congenital cardiac defects in which blood flow to the lungs depends on a patent ductus arteriosus. Moreover, prostaglandin E₁ infusion can be used to stabilize critically ill infants with coarctation of the aorta in whom blood flow to the descending aorta is dependent upon a patent ductus arteriosus. Recently, we infused prostaglandin E₁ into an infant with d-transposition of the great arteries who remained severely hypoxemic despite seemingly adequate balloon atrial septostomy. Prostaglandin E₁ infusion was associated with a prompt increase of arterial blood oxygen saturation.