From the Research
Flolan (epoprostenol) helps in Acute Respiratory Distress Syndrome (ARDS) primarily by improving ventilation-perfusion matching and reducing pulmonary hypertension, as evidenced by a study published in 2023 1. When administered as an inhaled medication, epoprostenol causes selective pulmonary vasodilation in well-ventilated areas of the lungs, which redirects blood flow away from poorly ventilated regions. This improves oxygenation by reducing shunting and optimizing gas exchange. Some key points to consider when using Flolan for ARDS include:
- The optimal dosing strategy for inhaled epoprostenol is still being researched, with a recent study suggesting that fixed-dose administration may be more effective than weight-based administration 1.
- Epoprostenol has anti-inflammatory and anti-platelet aggregation properties that may help mitigate the inflammatory cascade characteristic of ARDS.
- The medication also reduces right ventricular strain by decreasing pulmonary vascular resistance.
- Clinicians should monitor for potential side effects including hypotension, headache, and flushing.
- While not FDA-approved specifically for ARDS, epoprostenol is sometimes used as a rescue therapy when conventional treatments fail to improve oxygenation in severe cases. It's worth noting that the effectiveness of epoprostenol in ARDS has been studied in several trials, including a 2022 study that compared inhaled nitric oxide and epoprostenol in patients with acute respiratory failure 2, and a 2013 study that evaluated the efficacy and safety of inhaled epoprostenol in patients with ARDS 3. However, the most recent and highest-quality study on this topic is the 2023 study published in the American Journal of Health-System Pharmacy 1.