Sildenafil Therapy for Pulmonary Hypertension Before and After Pediatric Congenital Heart Surgery

摘要: Pulmonary hypertension associated with pediatric congenital heart defects is a major cause of postoperative morbidity and death. Sildenafil has been combined inhaled nitric oxide to treat pulmonary hypertension. We retrospectively studied the pre- effects oral sildenafil as monotherapy in children who underwent surgery correct cardiac defects. From September 2005 through November 2009, 38 moderate-to-severe arterial (pulmonary arterial/aortic pressure ratio, >0.7) at our institution. Fifteen patients were given (0.35 mg/kg, every 4 hr) orally or nasogastric tubes 1 week before after surgery. Twenty-three comparable medical status only upon institution cardiopulmonary bypass for Postoperatively, 15 preoperative had significantly lower mean pressures (25.6 ± 3.1 vs. 30.4 5.7 mmHg; P = 0.005) ratios 0.05 0.42 0.07; 0.002) than did other 23 patients. The therapy also shortened time, mechanical ventilation lengths intensive care unit hospital stays. No sildenafil-related hypertensive crises sequelae occurred. As monotherapy, low doses appears control safely effectively undergoing operations defects, particularly when it both preoperatively postoperatively. Further study warranted.