The Efficacy of Sildenafil Therapy in Children with Pulmonary Hypertension Postoperatively

  • Ms Feiqiong Huang, Singapore
  • Ms Xu Wang, Pediatric Cardiac Center, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science, Beijing Union Medical University,, China
  • Ms Yanbo Zhang, Pediatric Cardiac Center, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science, Beijing Union Medical University,, China
  • Ms Yan He, Pediatric Cardiac Center, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science, Beijing Union Medical University,, China
  • Ms Yajuan Zhang, Pediatric Cardiac Center, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science, Beijing Union Medical University,, China

    • Objective: Sildenafil is a Phosphodiesterase-5 inhibitor which is a potent pulmonary vasodilator. Some reports have been shown that it could decrease the pulmonary vascular resistance in adult patient with pulmonary hypertension. Few data in pediatrics postoperative pulmonary hypertension were established. In this study we try to evaluate the effect of oral Sildenafil in children with pulmonary hypertension postoperatively.
    Methods: Forty patients with congenital heart diseases who underwent pulmonary hypertension postoperatively were included in this study. All patients were ventilated with sedation and muscle relaxed. The pulmonary artery systolic pressure (PASP) was 58.22±8.31mmHg, Pp/Ps was 0.73±0.15, SO2 was 68.24±9.34 (FiO2>60%). After ventilation, using vasodilator,inhaling NO and O2, the decreased of pulmonary pressure was not satisfied, then Sildenafil was given from 0.3mg/dose,four times per day. If it didn’t work, the dosage increased to 0.5-2.0mg/dose (the largest dosage is 2.5mg/kg/dose). If pulmonary pressure began to decrease, the dosage was maintained till patients were stable.
    Result: The outcome of all the patients was good. The pulmonary pressure decreased (p<0.01), Pp/Ps was decreased (p<0.01), SO2 increased to 98%-100%(Fio2<40%), and all patients were extubated. Twelve patients had systemic hypotension, but made comeback soon without any intervention treatment.
    Conclusion: When pediatric patients with congenital heart disease suffered pulmonary hypertension postoperatively, sildenafil could decrease the pulmonary resistant and make an effect on pulmonary hypertension.