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. 2023 Aug 16;10(8):1397.
doi: 10.3390/children10081397.

Efficacy of Sildenafil in Infants with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension

Kacie Dillon  1 , Vineet Lamba  1 , Ranjit R Philip  2 , Mark F Weems  1 , Ajay J Talati  1
Affiliations

Efficacy of Sildenafil in Infants with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension

Kacie Dillon et al. Children (Basel). .

Abstract

Background: Pulmonary hypertension (PH) is a common comorbidity in infants with bronchopulmonary dysplasia (BPD). Sildenafil is a widely recognized therapy for PH, but its efficacy in infants with BPD is questionable. We propose to assess the efficacy of sildenafil in BPD-associated PH as evaluated based on transthoracic echocardiography (TTE) changes and clinical measures. Methods: Data were retrospectively and prospectively collected. Inclusion criteria were gestational age (GA) < 32 weeks, birth weight (BW) < 1500 g with severe BPD, diagnosis of PH via TTE on sildenafil treatment. PH was evaluated via TTE, which was performed monthly after 36 weeks post-menstrual age (PMA) as a standard of care, and re-reviewed by a single pediatric cardiologist, who was blind to the initial reading. Results: In total, 19 patients were enrolled in the study, having a median GA of 24 3/7 weeks (IQR 23 5/7-25 5/7) and a median BW of 598 g (IQR 572-735). Sildenafil treatment was started at a median PMA of 40.4 weeks. The median respiratory severity score (RSS) at 28 d was 6.5, RSS and FiO2 showed improvement about 12 weeks after starting sildenafil treatment. Conclusions: Improvement in PH was noted via TTE, and patients had improvement in their RSS and FiO2 after prolonged therapy. However, TTE improvements did not correlate with clinical improvements.

Keywords: BPD; bronchopulmonary dysplasia; pulmonary hypertension; sildenafil.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study population selection.
Figure 2
Figure 2
Comparisons between RSS and FiO2 at different CGAs prior to and following sildenafil treatment initiation.
Figure 3
Figure 3
Comparison between RSS at differing degrees of PH. PH is described numerically, with 1 = no PH, 2 = mild PH, 3 = moderate PH, and 4 = severe PH.
See this image and copyright information in PMC

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