Efficacy of Sildenafil therapy in Paediatrics & Neonates with Pulmonary Artery Hypertension– A study from a Tertiary Care University Hospital
Journal Title: International Journal of Medical and Health Sciences - Year 2014, Vol 3, Issue 3
Abstract
Background: Sildenafil citrate is one of the predominant drugs for treatment of paediatric and neonatal pulmonary artery hypertension (PAH). But there is an uncertainty in the current treatment pattern of sildenafil in children below 8kg body weight. Methodology: 43 paediatric and neonatal patients treated with sildenafil citrate for PAH were categorised based on their age and evaluated for the safety and the efficacy of sildenafil therapy. Patient demographics, pulmonary artery pressure, echocardiographic reports, drug therapy, adverse effects, World Health Organisation/New York Heart Association (WHO/NYHA) functional class and outcomes were noted. Adverse drug reactions were assessed using WHO & Naranjo’s causality assessment scales. Wilcoxon test was used for the comparison of WHO functional class & PAH pre and post sildenafil therapy. A p value of ≤ 0.05 was considered significant. Results: PAH associated with congenital systemic to pulmonary shunts (70%) was the major diagnosis observed. There was a significant improvement in the WHO/NYHA functional class pre and post sildenafil therapy from diagnosis Vs discharge (p < 0.001), diagnosis Vs first review phase (p < 0.001) and the discharge Vs review phase (p= 0.008). There were 36 patients with stable and satisfactory outcome, 2 with stable but not satisfactory outcome. 5 patients had unstable and deteriorating outcome resulting in death and the WHO & Naranjo’s causality assessments of these cases were unlikely. No side effects to sildenafil therapy were reported. Conclusion: In this study the sildenafil doses used were lower than new recommendations and the patients achieved stable and satisfactory outcome.
Authors and Affiliations
Anas. A, G. Kannan, R. Jebaraj, Vanitha Rani N
Keywords
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