Prostacyclin
Prostacyclin is mainly synthesized by vascular endothelium and smooth muscle. Effects include:
- inhibitor of platelet aggregation - does not influence platelet degranulation
- relaxation of smooth muscle
- reduction of systemic and pulmonary vascular resistance by direct vasodilation
- natriuresis in kidney
It may be used in ventilated infants who have high pulmonary vascular pressures, giving them a state of persistent fetal circulation. The response to prostacyclin in these circumstances should be rapid; the pulmonary pressure falls and blood flow through the lungs increases, with an increase in oxygenation.
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