Sildenafil (Viagra) in childhood and neonatal pulmonary hypertension

Erickson, Simon; Reyes, Janette T.; Bohn, D; Adatia, Ian

doi:10.1016/s0735-1097(02)81805-8

Cited by 28 publications

(24 citation statements)

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“…These reports all evaluate short-term treatment with sildenafil. In a case series of 16 patients, oral sildenafil significantly reduced mean pulmonary artery pressure from 50 ± 8 to 38 ± 12 mmHg during cardiac catheterization [5]. In 5 of the patients in this series, sildenafil allowed for discontinuation of inhaled nitric oxide 4-6 hours after an oral sildenafil dose [5].…”

Section: Discussionmentioning

confidence: 88%

Chronic Outpatient Sildenafil Therapy for Pulmonary Hypertension in a Child After Cardiac Surgery

2005

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Section: Discussionmentioning

confidence: 88%

Chronic Outpatient Sildenafil Therapy for Pulmonary Hypertension in a Child After Cardiac Surgery

2005

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“…Estudos e relatos da utilização do Sildenafil via oral nos pareceram promissores e foram determinantes para sua utilização [6][7][8][9] .…”

Section: Discussionunclassified

Sildenafil for pulmonary hypertension treatment after cardiac surgery

Bentlin¹,

Saito²,

Luca³

et al. 2005

J Pediatr (Rio J)

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ResumoObjetivo: Relatar o uso do Sildenafil no tratamento da hipertensão pulmonar em recém-nascido após cirurgia cardíaca.Descrição: Recém-nascido de termo, feminino, com diagnóstico de dupla via de saída de ventrículo direito, hipoplasia de pulmonar e comunicação interventricular subaórtica, foi submetido à cirurgia de Blalock na primeira semana de vida. No pós-operatório, evoluiu com hipertensão pulmonar e hipoxemia persistente, não-responsiva ao óxido nítrico, porém com melhora da oxigenação após infusão endovenosa contínua de prostaglandina E1. Depois de várias tentativas malsucedidas de retirada da prostaglandina E1, optou-se pela introdução do Sildenafil via oral. Houve queda da resistência vascular pulmonar, com conseqüente melhora na oxigenação e, 48 horas após, foi possível suspender a infusão de prostaglandina E1.Comentários: O Sildenafil pode ser alternativa terapêutica na hipertensão pulmonar, especialmente quando não houver resposta à terapia convencional. Sildenafil no tratamento da hipertensão pulmonar após cirurgia cardíacaSildenafil for pulmonary hypertension treatment after cardiac surgery To report on the use of sildenafil for pulmonary hypertension treatment of a newborn patient after cardiac surgery.Description: A female, full term newborn infant with diagnosis of double outlet right ventricle, pulmonary hypoplasia and subaortic ventricular septal defect, was submitted to Blalock surgery in the first week of life. In postoperative the newborn had pulmonary hypertension and persistent hypoxia, without response to nitric oxide, but with improved oxygenation after continuous intravenous infusion of prostaglandin E1. After several failed attempts to discontinue prostaglandin E1, oral sildenafil was used. There was a decrease in pulmonary vascular resistance with consequent oxygenation improvement and 48 hours later it was possible to discontinue prostaglandin E1 infusion.Comments: Sildenafil can be an alternative therapy for pulmonary hypertension, especially when there is no response to conventional therapy. J Pediatr (Rio J) IntroduçãoA hipertensão pulmonar, doença de alta morbimortalidade na infância, tem etiologia multifatorial e ocorre em aproximadamente 1,9 nascido vivo a cada 1.000. Caracteriza-se por aumento da resistência vascular pulmonar, resultando em shunt da direita para a esquerda, com passagem de sangue não-oxigenado pelo ducto arterioso ou forame oval 1 .O tratamento objetiva a estabilização cardiovascular, a melhora da oxigenação e a redução da pressão na artéria pulmonar. No tratamento 1-3 , têm sido utilizados oxigênio, antagonistas de canais de cálcio, prostaciclinas e análogos, antagonistas dos receptores da endotelina e vasodilatadores, como óxido nítrico, mas, apesar de todo avanço terapêutico, apenas 50% dos pacientes apresentam resposta clínica 1 . Assim, têm sido investigadas novas opções terapêuticas, incluindo inibidores da enzima 5-fosfodiesterase como o sildenafil, que promove aumento da concentração de guanosina monofosfato cíclico (GMPc) e conseqüente vasodilata...

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“…Studies and reports of the oral administration of sildenafil seemed to be promising and were a determining factor for its use. [6][7][8][9] Sildenafil was studied in animal models of pulmonary hypertension, revealing to be a selective pulmonary vasodilator with no effects on systemic arterial pressure, enhancing the effects of inhaled nitric oxide (iNO) when given orally or intravenously. 5,10 It is a potent inhibitor of phosphodiesterase-5, which is responsible for the conversion of cGMP into GMP.…”

Section: Discussionmentioning

confidence: 99%

“…The use of sildenafil in children has been described only in case reports [6][7][8][9] and in one randomized study that compared the use of iNO and intravenous sildenafil. 14 There are three reports of pulmonary hypertension after heart surgery in infants aged 1 day, 6 weeks and 4 months.…”

Section: Discussionmentioning

confidence: 99%

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Sildenafil no tratamento da hipertensão pulmonar após cirurgia cardíaca

Bentlin¹,

Saito²,

Luca³

et al. 2005

J. Pediatr. (Rio J.)

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Objective: To report on the use of sildenafil for pulmonary hypertension treatment of a newborn patient after cardiac surgery.Description: A female, full term newborn infant with diagnosis of double outlet right ventricle, pulmonary hypoplasia and subaortic ventricular septal defect, was submitted to Blalock surgery in the first week of life. In postoperative the newborn had pulmonary hypertension and persistent hypoxia, without response to nitric oxide, but with improved oxygenation after continuous intravenous infusion of prostaglandin E1. After several failed attempts to discontinue prostaglandin E1, oral sildenafil was used. There was a decrease in pulmonary vascular resistance with consequent oxygenation improvement and 48 hours later it was possible to discontinue prostaglandin E1 infusion.Comments: Sildenafil can be an alternative therapy for pulmonary hypertension, especially when there is no response to conventional therapy.J Pediatr (Rio J). 2005;81(2):175-8: Sildenafil, pulmonary hypertension, prostaglandin.

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Sildenafil (Viagra) in childhood and neonatal pulmonary hypertension

Cited by 28 publications

References 0 publications

Chronic Outpatient Sildenafil Therapy for Pulmonary Hypertension in a Child After Cardiac Surgery

Chronic Outpatient Sildenafil Therapy for Pulmonary Hypertension in a Child After Cardiac Surgery

Sildenafil for pulmonary hypertension treatment after cardiac surgery

Sildenafil no tratamento da hipertensão pulmonar após cirurgia cardíaca

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