Effect of intravenous sildenafil on pulmonary hemodynamics and gas exchange in the presence and absence of acute lung injury in piglets

Pediatric Research
Pia K RyhammerHanne B Ravn

Abstract

Sildenafil is becoming increasingly popular for the treatment of pulmonary hypertension. However, there are potential concerns regarding its effects on oxygenation and systemic hemodynamics that could theoretically reduce its utility in the neonatal population. We performed a prospective cumulative dose-response study of increasing doses of i.v. sildenafil (0.4, 1, and 3 mg/kg) on hemodynamics and oxygenation in 32 anesthetized piglets, of which 17 had meconium-induced pulmonary hypertension and lung injury, and 15 did not. Sildenafil caused a reduction in mean pulmonary artery pressure and pulmonary vascular resistance (PVR) at all doses, in non-lung-injured animals. There was no difference in pulmonary hemodynamics between doses. Oxygenation index [OI = mean airway pressure (cm H2O) * FiO2 * 100/PaO2 (mm Hg)] did not reach critical levels at any dose. In lung-injured animals, sildenafil also reduced mean pulmonary artery pressure and PVR by 30%. Again, this effect was achieved at the lowest dose, without subsequent changes at higher doses. However, in lung-injured animals, sildenafil produced a dose-related increase in oxygenation index. Sildenafil reduced the systemic vascular resistance (SVR) at the lowest dose in lung-inju...Continue Reading

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Citations

Mar 20, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Alain Fraisse, David L Wessel
Aug 19, 2006·American Journal of Respiratory and Critical Care Medicine·Poongundran NamachivayamLara S Shekerdemian
Mar 1, 2012·Asian Cardiovascular & Thoracic Annals·Zhiyong Liu, Lei Fang
Jun 16, 2018·Pediatric Pulmonology·Daniela MokraKatarina Matasova
May 5, 2020·The International Journal of Risk & Safety in Medicine·Dick Bijl, David Healy
Mar 7, 2021·International Journal of Molecular Sciences·Daniela Mokra, Juraj Mokry
Jun 13, 2021·Brazilian Journal of Anesthesiology·Daniella Aparecida Godoi KemperDenise Tabacchi Fantoni

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