Journal
ARCHIVES OF DISEASE IN CHILDHOOD
Volume 98, Issue 8, Pages 613-617Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/archdischild-2012-303333
Keywords
Paediatric; Respiratory; pulmonary hypertension; sildenafil; bronchopulmonary dysplasia
Categories
Funding
- Pfizer
- GSK
- Actelion
- Encysive
Ask authors/readers for more resources
The treatment of pulmonary hypertension (PH) secondary to bronchopulmonary dysplasia (BPD) in infants has evolved in recent years, improving both quality of life and survival for patients. One of the potential agents for this condition is sildenafil, a phosphodiesterase-V inhibitor with proven efficacy within the idiopathic PH population. However, only limited evidence exists for its use as either monotherapy or part of a combination approach towards the management of PH in BPD. This review summarises the evidence base for sildenafil alone and in combination with other recognised therapeutic agents for ameliorating paediatric PH in the presence of BPD. It also examines the suitability for current practice with the aim of clarifying regimens that produce improved patient outcomes. We conclude that sildenafil is both safe and effective in this utility. Doses should be started at 0.5mg/kg every 8h before titrating up towards 2mg/kg every 6h to effect reductions in pulmonary vascular resistance and arterial pressure. Evidence suggests that if continued until PH resolution, this improves survival from 61% to 81% at 12months. Furthermore, there are also data suggesting that in treatment refractory PH cases, the addition of endothelin antagonists and prostacyclin analogues to sildenafil therapy can also be considered.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available