PPHN: is sildenafil the new nitric? A review of the literature

Adv Neonatal Care. 2010 Apr;10(2):69-74. doi: 10.1097/ANC.0b013e3181d5c501.

Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening neonatal pathology resulting from poor hemodynamic and respiratory transition to extrauterine life. Inhaled nitric oxide (iNO) is a current, commonly used treatment of PPHN. However, some infants with PPHN do not respond to iNO therapy. Because of the significant morbidity and mortality associated with PPHN, it is useful to look at other possible therapies. This article explores the use of sildenafil in the treatment of PPHN, either as a supplement to iNO or as an alternative to iNO. Current research, including a case study, is reviewed. An emphasis is placed on the administration and efficacy of sildenafil in synergy with, and in lieu of, current iNO therapy in the treatment of PPHN.

Publication types

  • Review

MeSH terms

  • Bronchodilator Agents / therapeutic use
  • Drug Therapy, Combination
  • Evidence-Based Practice
  • Humans
  • Infant, Newborn
  • Intensive Care, Neonatal
  • Neonatal Nursing
  • Nitric Oxide / therapeutic use
  • Persistent Fetal Circulation Syndrome / diagnosis
  • Persistent Fetal Circulation Syndrome / drug therapy*
  • Persistent Fetal Circulation Syndrome / epidemiology
  • Phosphodiesterase Inhibitors / pharmacology
  • Phosphodiesterase Inhibitors / therapeutic use*
  • Piperazines / pharmacology
  • Piperazines / therapeutic use*
  • Purines / pharmacology
  • Purines / therapeutic use
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Sildenafil Citrate
  • Sulfones / pharmacology
  • Sulfones / therapeutic use*
  • Treatment Outcome
  • Vasodilator Agents / pharmacology
  • Vasodilator Agents / therapeutic use*

Substances

  • Bronchodilator Agents
  • Phosphodiesterase Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Vasodilator Agents
  • Nitric Oxide
  • Sildenafil Citrate