Sildenafil Ameliorates Effects of Inhaled Nitric Oxide Withdrawal

Atz, Andrew M.; Wessel, David

doi:10.1097/00000542-199907000-00041

Cited by 308 publications

(175 citation statements)

References 12 publications

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“…No rebound pulmonary hypertension was observed in the 36 hours after the nitric oxide was discontinued. Atz and Wessel [3] observed similar findings in three patients with pulmonary hypertension. Sildenafil administration facilitated withdrawal of nitric oxide in these patients with no rebound pulmonary hypertension observed.…”

Section: Discussionsupporting

confidence: 57%

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

2005

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Section: Discussionsupporting

confidence: 57%

“…Other reports have shown that oral sildenafil may aid in the successful withdrawal of nitric oxide [2,3]. Sildenafil initiation in a 9-month-old with congenital heart disease allowed the weaning of nitric oxide while inducing no further pulmonary hypertensive episodes [2].…”

Section: Discussionmentioning

confidence: 98%

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

2005

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“…41 Initial success has been noted in some pediatric cases in attenuation of INO-rebound pulmonary hypertension. 42 Baquero et al, 27 in a proof-of-concept, randomized masked study showed an improvement in oxygenation index and pulse oxygen saturation within 6 to 30 h, and significant increase in survival rate (85%, 6/7 infants) in those randomized to receive oral sildenafil. In the placebo group only 1/6 (16%) survived.…”

Section: Phosphodiesterase Inhibitorsmentioning

confidence: 97%

Pharmacotherapy for meconium aspiration

Asad

Bhat

2008

J Perinatol

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In this article we have attempted to review the current pharmacological treatment options for infants with meconium aspiration syndrome with or without persistent pulmonary hypertension. These treatments include ventilatory support, surfactant treatment and inhaled nitric oxide (INO), in addition to older and newer pharmacological treatments. These include sedatives, muscle relaxants, alkali infusion, antibiotics and the newer vasodilators. Many aspects of treatment, including ventilatory care, surfactant treatment and the use of INO, are reviewed in great detail in this issue. On the other hand, many newer pharmacological modalities of treatment described here have not been evaluated with randomized control trials. We have given an overview of these emerging therapies.

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“…Sildenafil, a PDE5 inhibitor, improves both cardiovascular function and oxygenation in patients with CDH [31]. Moreover, sildenafil may increase the efficacy of iNO and may prevent rebound pulmonary hypertension during weaning of iNO and hence help in the management of chronic PH [32]. Prostacyclin (PGI 2 ), which acts via the cAMP pathway, has been used in isolated cases of CDH [33]; however, its effects have not been studied systematically.…”

Section: Management Of Pulmonary Hypertensionmentioning

confidence: 99%

Current Concepts in the Management of Congenital Diaphragmatic Hernia in Infants

Kumar

2015

Indian J Surg

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The therapeutic approach to congenital diaphragmatic hernia (CDH) has shifted from one of immediate repair to management of pulmonary hypertension, physiologic stabilization, and delayed surgical repair. Lung hypoplasia, remodeled pulmonary vasculature, and ventricular dysfunction all contribute to the high morbidity and mortality associated with CDH. In addition, genetic syndromes associated with CDH can increase the incidence of serious anomalies and hence impact survival. Prenatal and postnatal management of infants with CDH is challenging in the best of circumstances and need multidisciplinary teams for optimal outcomes. However, advances using ultrasound and fetal MRI can predict prognosis and survival and plan for postnatal management. Survival rates for patients with CDH have increased for the past decade with better management at resuscitation; implementation of gentle ventilation strategies; and medical management of pulmonary hypertension, physiologic stabilization, and extracorporeal membrane oxygenation. However, follow-up of these infants for long-term morbidities is essential for optimal outcomes after discharge. . Lung hypoplasia and pulmonary hypertension are key factors which contribute to the morbidity and mortality associated with CDH.

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Sildenafil Ameliorates Effects of Inhaled Nitric Oxide Withdrawal

Cited by 308 publications

References 12 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

Pharmacotherapy for meconium aspiration

Current Concepts in the Management of Congenital Diaphragmatic Hernia in Infants

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