Inhaled bronchodilators are often given in preterm infants with evolving or established bronchopulmonary dysplasia. However, it is unclear which patients may benefit from it and when it is the best time to start treatment. The forced oscillation technique (FOT) is a noninvasive method for assessing lung mechanics that proved sensitive to airway obstruction reversibility in children and adults. FOT does not need patient cooperation, which is ideal for infants. Bedside tools for applying FOT in infants during spontaneous breathing and different respiratory support modes are becoming available. This case report illustrates for the first time that FOT has potential value in assessing airway obstruction reversibility in preterm infants, informing which infants may manifest a clinical benefit from the treatment with bronchodilators.
Inhaled bronchodilators are often given in preterm infants with evolving
or established bronchopulmonary dysplasia. However, it is unclear which
patients may benefit from it and when it is the best time to start
treatment. The forced oscillation technique (FOT) is a noninvasive
method for assessing lung mechanics that proved sensitive to airway
obstruction reversibility in children and adults. FOT does not need
patient cooperation, which is ideal for infants. Bedside tools for
applying FOT in infants during spontaneous breathing and different
respiratory support modes are becoming available. This case report
illustrates for the first time that FOT has potential value in assessing
airway obstruction reversibility in preterm infants, informing which
infants may manifest a clinical benefit from the treatment with
bronchodilators.
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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.