Inpatient Transition From Intravenous to Inhaled Treprostinil in a Pediatric Patient

We report a case of a 7-year old male with idiopathic pulmonary arterial hypertension, successfully transitioned from an intravenous infusion to inhaled treprostinil during inpatient admission, after his intentional removal of multiple central venous catheters. He had no clinical, echocardiographic, or serum biomarker evidence of loss of control of pulmonary arterial hypertension during the 4-day transition. The patient was discharged home without complications, and 3 weeks after discharge the patient’s pulmonary hypertension remained well controlled per clinical and echocardiographic evidence, including a significantly improved 6-minute walk distance test. ABBREVIATIONS CVC, central venous catheter; FiO₂, fraction of inspired oxygen; iNO, inhaled nitric oxide; IV, intravenous; mPAP, mean pulmonary arterial pressure; NT-proBNP, N-terminal pro–brain-type natriuretic peptide; PAH, pulmonary arterial hypertension; RV, right ventricular; 6MWD, 6-minute walk distance; SQ, subcutaneous; TR, tricuspid regurgitation; WHO, World Health Organization.