FDA Approval of Epoprostenol to Treat Primary Pulmonary Hypertension
https://doi.org/10.1002/pul2.70149
Abstract
In 1976, my wife and I moved to Salt Lake City to start my fellowship in pulmonary and critical care medicine. The University of Utah program had applied principles of physiology to the care of critically ill patients; and that interested me. As a critical care fellow, I learned to perform pulmonary artery catheterization and to interpret hemodynamic measurements in patients with adult respiratory distress syndrome (ARDS).
During my second year of the fellowship, I aimed to conduct research to improve the survival of ARDS patients. Many of our ARDS patients had pulmonary hypertension (PH) and right heart failure. I read diligently about PH, including Paul Wood's classic publication on the role of vasoconstriction [1], and I concluded that vasodilators might improve survival in severe ARDS. In 1977, Priscoline, previously reported to benefit patients with severe primary pulmonary hypertension (PPH) [2], was the only intravenous vasodilator available to me. I organized a study of Priscoline treatment of severe PH complicating ARDS. My study ended after three patients failed to improve. No abstract or manuscript was published, but my interest in PH and vasodilators had begun. I thought that I needed to focus on PPH rather than ARDS.