Changes in mean arterial blood pressure during sildenafil use in neonates with meconium aspiration syndrome or sepsis.
The aim of this study was to evaluate changes in mean blood pressure (MBP) in late preterm and term newborns with meconium aspiration syndrome (MAS) or sepsis who, in addition to inhaled nitric oxide (iNO), received enteral sildenafil for treatment of persistent pulmonary hypertension of the newborn. Data on sildenafil dosing, MBP, and vasopressor/inotrope use were collected for 72 hours after initiation of sildenafil. Groups were compared between "low dose" (<3 mg·kg·d) versus "high dose" (≥ 3 mg·kg·d) and "early" (<7 postnatal days) versus "late" (≥ 7 postnatal days) administration of sildenafil. Seventeen patients were identified. Ten and 7 patients received "low-dose" and "high-dose" sildenafil, respectively, and 8 and 9 patients were started on sildenafil "early" and "late," respectively. At the doses used, sildenafil treatment of infants with MAS and sepsis was not associated with changes in MBP. In addition, vasopressor/inotropic support was weaned in all groups. During the first 72 hours of enteral sildenafil administration in neonates with pulmonary hypertension of the newborn secondary to MAS or sepsis, no significant decrease in MBP or increase in vasopressor/inotrope requirement occurred.
1Department of Pediatrics, Division of Neonatology, Meriter Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI 2Department of Pediatrics, USC Division of Neonatal Medicine and the Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles and LAC + USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Jamie
J
Limjoco
Lisa
L
Paquette
Rangasamy
R
Ramanathan
Istvan
I
Seri
Philippe
P
Friedlich
D062186:Arterial Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000150:complications*; D009569:Nitric Oxide / Q000008:administration & dosage; D010547:Persistent Fetal Circulation Syndrome / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications*; D000068677:Sildenafil Citrate / Q000008:administration & dosage* / Q000494:pharmacology; D013997:Time Factors
D009569:Nitric Oxide; D000068677:Sildenafil Citrate