Outcomes of Newborn Infants With Pulmonary Hypertension Treated With Oral Sildenafil

Abstract

Background: Persistent pulmonary hypertension of the newborn (PPHN) is a disease with a high mortality rate. The incidence of PPHN is approximately 0.8 per 1,000 live births. Inhaled nitric oxide remains the treatment of choice, but in areas where inhaled nitric oxide is not available, sildenafil citrate is considered the best alternative vasodilator. We conducted this study to investigate the efficacy of oral sildenafil in treating neonatal pulmonary hypertension. Methods: This is a retrospective study of all newborns diagnosed with PPHN who received oral sildenafil over an 8-year period. Results: A total of 27 newborns were included in the study. The most common primary disease was respiratory distress syndrome. The mortality rate was 44.4%; all newborns with cardiovascular shock at presentation died. Conclusions: Oral sildenafil is a promising medication that can help neonates with mild to moderate PPHN in hospital units where inhaled nitric oxide is not available. Development of a treatment protocol to standardize the care of such infants will positively impact outcomes.