Q:   Due to history of pulmonary hypertension, 36 year old female is admitted to ICU for observation. Patient is on Epoprostenol via PICC line. During transport PICC line fell out by 6 cm. 'Pulmonary HTN' team requested to change or insert a new PICC line. What precaution is extremely important to take?


Answer:  Epoprostenol has a very short half-life of  about 2-3 mins. Moreover, it is unstable at room temperature. Extreme caution should be taken while changing or priming catheter as any change in dose, incidental bolus or interruption of the infusion can cause severe rebound pulmonary hypertension, which may become fatal.