Routine Sildenafil Does Not Improve Clinical Outcomes After Fontan Operation

摘要: Fontan operation can be complicated by persistent chest tube output (CTO) leading to prolonged hospital length of stay (LOS). Postoperative sildenafil administration has been shown improve clinical outcomes in selected patients after Fontan. We initiated a practice change utilizing intravenous (IV) early postoperative period all undergoing with aim decrease LOS and CTO. Nineteen (February 2014-May 2016) received 0.35 mg/kg IV (three doses) followed enteral, 1 every eight hours until discharge. Clinical were compared 84 pre-protocol controls. Vital signs recorded second dose. Demographics similar between groups. Sildenafil group had longer median [9 (7, 11) vs. 13 (8, 25) days, p = 0.016]. CTO days [6 (5, 8) 8 (6, 13) 0.011]. mechanical ventilation [6.9 (3.5, 11.1) 4 (2, 7) h, 0.045] oxygen therapy [99 (52, 225) 14.5 (14, 56) 0.001]. There was trend towards more albumin 5% resuscitation first 24 h [17 (1, 30) 21 (10, 40) ml/kg, 0.069]. no difference inotrope score at maximum lactate, or fluid balance. Readmission rates similar. mortality. well tolerated, doses held. Routine is not associated an improvement any measured outcome, including CTO, LOS, colloid administration, duration ventilation.