Role of oral sildenafil in neonates with persistent pulmonary hypertension of newborn


  • Arohi Gupta Department of Paediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Mala Kumar Department of Paediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Tarun Anand Fellow in Neonatology, Max Hospital, New Delhi, India



Neonate, Persistent pulmonary hypertension of the newborn, phosphodiesterase inhibitors, Persistent pulmonary hypertension, Sildenafil, Neonatal intensive care unit


Persistent pulmonary hypertension of newborn is a devastating condition and leads to morbidity and mortality. Even after the increasing use of  NO, ECMO and HFO many patients succumb to death. About 50% of the patients either have rebound hypertension or do not respond to the treatment. Hence the role of phosphodiesterase inhibitors (sildenafil) need to be evaluated. Methods is authors report a retrospective case series of 24 patients with PPHN admitted in NICU and treated with oral sildenafil. Results sildenafil was started on all patients on a mean of 1.46 days and stopped on mean of 3.8 days. Initial fio2 was 100%, which after starting sildenafil decreased gradually to 50% on mean of 10 days. Average length of stay in NICU was 20 days. 17(70.8%) patients survived whereas 7 (29%) expired No improvement in oxygen Index after 48 hours (p<0.05) was the independent predicting risk factor for PPHN related mortality in the expired patients.Conclusion are oral sildenafil can be a used in conjunction with other treatment modalities for PPHN especially in resource limited settings.


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