Intravenous Sildenafil i. v. as Rescue Treatment for Refractory Pulmonary Hypertension in Extremely Preterm Infants

Steiner, Manuel; Salzer, Ulrich; Baumgartner, Sigrid; Waldhoer, Thomas; Klebermass-Schrehof, Katrin; Wald, Martin; Langgartner, Michaela; Berger, Angelika

doi:10.1055/s-0034-1375697

Cited by 23 publications

(18 citation statements)

References 9 publications

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“…congenital heart defects). Enteral sildenafil was used in most of the 13 observational studies, although intravenous sildenafil, 36,38 enteral vardenafil, 40 and enteral tadalafil 35 (Table 3, Supplemental Tables 6-8) were used in a few studies. PDE5 inhibitor doses and dosing intervals were highly variable in both RCTs and observational studies (Tables 2 and 3, Supplemental Tables 6-8).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…No abnormal auditory or ophthalmologic exams were noted at the time of discharge. Steiner et al (2014) 36 AE with sildenafi l: pulmonary hemorrhage (2/6 patients, at a time point when signifi cant improvement of PH had already taken place; both survived) Fang et al (2013) 39 AE: Stage 3 ROP, 4 (23.5%) in sildenafi l group, 6 (11.8%) in controls; progression of ROP, 5(29%) in sildenafi l group, 12 (24%) in controls; OR (sildenafi l) = 1.35, 95% CI, 0.39-4.62; P = .63. SAE: 1 infant in each group required laser treatment.…”

Section: Are Pde5 Inhibitors Effective In Improving Clinical Outcomesmentioning

confidence: 99%

“…Although the 2 other studies indicated an increased need for inotropic support, 16,47 this was only a significant finding in 1 of the 2 studies (P = .00) ( Table 3, Supplemental Table 17). 34,36 Clinical Outcomes: Addition and/or Weaning of PH Medications…”

Section: Are Pde5 Inhibitors Effective In Improving Clinical Outcomesmentioning

confidence: 99%

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Pulmonary Hypertension Therapy and a Systematic Review of Efficacy and Safety of PDE-5 Inhibitors

Unegbu¹,

Noje²,

Coulson

et al. 2017

Pediatrics

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Pulmonary hypertension (PH) is a syndrome that is of growing concern to pediatricians worldwide. Recent data led to concerns about the safety of phosphodiesterase type 5 (PDE5) inhibitors in children and a US Food and Drug Administration safety advisory. Our objective is to provide insight into therapies for PH in children and to systematically review the comparative effectiveness and safety of PDE5 inhibitors in the management of pediatric patients with PH. We searched the following databases through February 2015: Medline, Embase, SCOPUS, and the Cochrane Central Register of Controlled Trials. We included studies that examined PDE5 inhibitor use in children with PH. Allowed comparators were either no medication or other classes of medication for management of PH. Study inclusion was via a 2-stage process with 2 reviewers and a predesigned form. Of 1270 papers identified by the literature search, 21 were included: 8 randomized controlled trials and 13 observational studies (9 retrospective, 4 prospective). There is strong evidence that PDE5 inhibitor use improves echocardiography measurements, cardiac catheterization parameters, and oxygenation compared with baseline or placebo in pediatric patients with PH. Evidence suggests that low- and moderate-dose sildenafil are safe regimens for children. There are a relatively small number of randomized controlled trials that address use of PDE5 inhibitors in pediatric patients with PH. PDE5 inhibitors are effective agents for cardiovascular and oxygenation end points in pediatric PH and important components of a multimodal pharmacotherapeutic approach to this growing challenge. Additional studies are needed to define optimal PH therapy in childhood.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Are Pde5 Inhibitors Effective In Improving Clinical Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Hypertension Therapy and a Systematic Review of Efficacy and Safety of PDE-5 Inhibitors

Unegbu¹,

Noje²,

Coulson

et al. 2017

Pediatrics

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show abstract

“…Secondly, neonatologists must be aware of the fact that persistent pulmonary hypertension may aggravate the clinical course of affected very preterm neonates with respect to cardiopulmonary function. Several therapeutic options are currently available for persistent pulmonary hypertension in very preterm infants [9,11]. Apart from cardiopulmonary problems, contractures not being a major challenge actually for neonatal intensive care, but potentially causing some long-term problems must be anticipated [1].…”

mentioning

confidence: 99%

Preterm Premature Rupture of Membranes: A Constant Challenge in Perinatal Medicine?

Gortner¹

2016

Klin Padiatr

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Two recently published observational studies have focused on the outcome of very preterm respectively of very low birth weight infants after preterm premature rupture of fetal membranes (PPROM). One single center study from the Netherlands enrolling 160 women with PPROM before 24 weeks gestational age, who admitted to the Rotterdam Medical Center between 2002 and 2011, were analyzed 14. In parallel, there was a publication from the German Neonatal Network (GNN) enrolling about 6,000 very low birth weight infants, whose data were analyzed under the aspect of PPROM as a potential risk factor for adverse neonatal outcomes 5.

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“…Several therapeutic options are currently available for persistent pulmonary hypertension in very preterm infants [9,11]. Apart from cardiopulmonary problems, contractures not being a major challenge actually for neonatal intensive care, but potentially causing some long-term problems must be anticipated [1].…”

mentioning

confidence: 99%

Untitled

2016

Klin Padiatr

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Intravenous Sildenafil i. v. as Rescue Treatment for Refractory Pulmonary Hypertension in Extremely Preterm Infants

Cited by 23 publications

References 9 publications

Pulmonary Hypertension Therapy and a Systematic Review of Efficacy and Safety of PDE-5 Inhibitors

Pulmonary Hypertension Therapy and a Systematic Review of Efficacy and Safety of PDE-5 Inhibitors

Preterm Premature Rupture of Membranes: A Constant Challenge in Perinatal Medicine?

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