The use of sildenafil in the treatment of persistent pulmonary hypertension of the newborn: a review of the literature

Current Pharmaceutical Design
Nicoletta IacovidouTheodoros Xanthos

Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a serious and potentially fatal condition, characterized by hypoxemia due to increased pulmonary vascular resistance (PVR) with resultant shunting of pulmonary blood to the systemic circulation. Inhaled nitric oxide (iNO) has been considered a revolutionary treatment of PPHN. Data show that the use of iNO has reduced the need of ECMO in neonates with severe PPHN, while in moderate PPHN, iNO administration has been associated with a significant decrease in ventilatory support and prevented progression to severe PPHN. Not all neonates respond to iNO therapy though, and phosphodiesterase (PDE) inhibitors with their potent vasodilator properties have evolved as an alternative therapy or as an adjunct to the treatment of PPHN with iNO. There are ten families of PDE isoenzymes. PDE 5 is particularly prevalent in vascular smooth muscle (VSM) and PDE 5 inhibitors, such as sildenafil, have been used in clinical practice. This review provides a comprehensive account of existing data in the literature, from animal and clinical studies, on the use of sildenafil for the treatment of PPHN. Sildenafil may also have a role as a single mode of therapy, since in resource-limited settings...Continue Reading

Citations

Oct 23, 2015·Clinical Therapeutics·Krystle M Perez, Matthew Laughon
Apr 29, 2015·Journal of Perinatology : Official Journal of the California Perinatal Association·D T Malleske, B A Yoder
Aug 5, 2017·The Cochrane Database of Systematic Reviews·Lauren E KellyPrakeshkumar S Shah
Dec 23, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Yao LuuStacy D Brown
Feb 20, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·K M GroomP N Baker
Nov 21, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Giuseppe CalcaterraFrancesco Romeo

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