Abstract
Objective: We aimed to compare the effect of the combined therapy, sildenafil and inhaled nitric oxide with inhaled nitric oxide monotherapy for the treatment of Pulmonary Hypertension of the Newborn.Study Design: Newborn infants (gestational age greater than 34 weeks) who were diagnosed with pulmonary hypertension between December 2008 and 2010 were retrospectively evaluated. Group I (n=14) received monotherapy with inhaled nitric oxide and Group II (n=9) received combined therapy with inhaled nitric oxide and oral sildenafil. Primary outcome was to compare the duration of inhaled nitric oxide therapy between groups.Results: Demographic characteristics were similar between the groups. Combination therapy was associated with early weaning of inhaled nitric oxide (4.8±1.5 vs. 13.5±7.6 hours). The duration of inhaled nitric oxide therapy was slightly shorter in combined therapy group (75[24-125] vs. 109[24-210] hours), however, the difference was insignificant (p=0.2). The incidence of mortality and neonatal outcomes were similar between the groups (p>0.05).Conclusion: Combined therapy did not result in shorter duration of inhaled nitric oxide therapy. Further well designed and larger studies that will elucidate the benefits of combination therapies and optimal therapy whereinhaled nitric oxide is not available are warranted.
Highlights
Combination therapy was associated with early weaning of inhaled nitric oxide (4.8±1.5 vs. 13.5±7.6 hours)
The duration of inhaled nitric oxide therapy was slightly shorter in combined therapy group (75[24-125] vs. 109[24-210] hours), the difference was insignificant (p=0.2)
Combined therapy did not result in shorter duration of inhaled nitric oxide therapy
Summary
Persistent pulmonary hypertension of the newborn (PPHN) is a potentially life-threatening condition which is associated with increased pulmonary vascular resistance, ventilation-perfusion mismatch, and right-to-left shunting resulting. Submitted for Publication: 31.12.2016 Accepted for Publication: 28.03.2017. Quick Response Code: Access this article online Website: www.gorm.com.tr. How to cite this article: Kanmaz HG. The Impact of Combined Oral Sildenafil and Inhaled Nitric Oxide for Treating Persistent Pulmonary Hypertension of the Newborn: A Single Center Experience. Gynecol Obstet Reprod Med 2017;23(2):100 in systemic hypoxia. The prevalence of PPHN has been estimated at 1.9 per 1000 live births [1]
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