Oral Sildenafil for pulmonary hypertension associated with congenital heart disease in children – single center, prospective, pilot study

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Original Article

Author Details : Vinayak Patki, Subodh Dhanawade, Jennifer Antin

Volume : 2, Issue : 4, Year : 2016

Article Page : 162-165

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Abstract

Objective: To study the efficacy of oral sildenafil for pulmonary hypertension (PH) in children associated with congenital heart disease.
Methods: This was a prospective observational study carried at Neonatal and Pediatric Intensive Care Unit of tertiary care hospital for a period of 1 year. Fifty children with pulmonary hypertension associated with congenital heart disease  were given Sildenafil at a dose of 1mg/kg /dose 6 hourly either oral or through nasogastric tube & were followed up for a period of six months clinically & with serial echocardiography.
Results: Pulmonary hypertension was observed more in female (64%) patients. Majority (88%) of children had moderate to severe pulmonary hypertension. All children were malnourished. Cardiomegaly (92%), Respiratory distress (76%), congestive cardiac failure (76%), Anemia (84%) & pneumonia (52%) were common clinical presentations in these children. Mean pulmonary pressure at admission was 62.92±17.48 mm of Hg. There was significant (p-0.00) reduction in serial pulmonary pressures (at 2 weeks 51.71±19.06, at 1 month 48.42±21.55, at 3 month 37.92±20.85 and at 6 month 29.27±14.40mm of Hg). Sildenafil has reduced the pulmonary pressures in all grades of pulmonary Hypertension. Episodes of congestive cardiac failure and pneumonia were reduced after sildenafil treatment. Sildenafil was tolerated well in patients of all grades of pulmonary hypertension with a very few side effects  like diarrhea (10%), flushing(8%) and tachycardia (6%).
Conclusion: Sildenafil which is easily available, inexpensive & well tolerated drug not only reduces pulmonary pressures in patients of all grades pulmonary hypertension but also reduces episodes of congestive cardiac failure and pneumonia.

Keywords: Sildenafil,Pulmonary Hypertension,Critically ill children, PICU

How to cite : Patki V, Dhanawade S, Antin J, Oral Sildenafil for pulmonary hypertension associated with congenital heart disease in children – single center, prospective, pilot study. IP Int J Med Paediatr Oncol 2016;2(4):162-165

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