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Oral sildenafil for treatment of severe pulmonary hypertension in an infant.

Hon KL, Cheung KL, Siu KL, Leung TF, Yam MC, Fok TF, Ng PC

Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, SAR, China.

We report the use of oral sildenafil in a 5-month-old preterm infant with severe bronchopulmonary dysplasia and pulmonary arterial hypertension refractory to inhaled nitric oxide treatment, maximal ventilatory support and conventional vasodilator therapy. Sildenafil was prepared as a liquid suspension by the method of trituration and administered via an orogastric tube to the patient. Forty-eight hours after sildenafil treatment, echocardiography revealed that the tricuspid incompetence was substantially diminished and the contractility of both ventricles improved, indicating a marked reduction in pulmonary arterial pressure. Oral sildenafil treatment was continued for 6 months until complete resolution of pulmonary arterial hypertension, and oxygen supplement was weaned off. There was no adverse effect during the treatment period. Oral sildenafil may be useful in reducing pulmonary vascular resistance and can be considered for treatment of severe pulmonary arterial hypertension secondary to bronchopulmonary dysplasia.

Published 11 August 2005 in Biol Neonate, 88(2): 109-12.
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