期刊
JOURNAL OF PEDIATRICS
卷 154, 期 3, 页码 379-384出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2008.09.021
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类别
资金
- Thrasher Foundation
- NIH [NCCR S K23 RR021021, NHLBI IROI HL085703]
Objective To determine the clinical course and outcomes of infants with chronic lung disease (CLD) and pulmonary hypertension (PH) who received prolonged sildenafil therapy. Study design We conducted a retrospective review of 25 patients <2 years of age with CLD in whom sildenafil was initiated for the treatment of PH while they were hospitalized from January 2004 to October 2007. Hemodynamic improvement was defined by a 20% decrease in the ratio of pulmonary to systemic systolic arterial pressure or improvement in the degree of ventricular septal flattening with serial echocardiograms. Results Chronic sildenafil therapy (dose range. 1.5-8.0 mg/kg/d) was initiated at a median of 171 days of age (range, 14-673 days of age) for a median duration of 241 days (range, 28-950 days). Twenty-two patients (88%) achieved hemodynamic improvement after a median treatment duration of 40 days (range, 6-600 days). Eleven of the 13 patients with interval estimates of systolic pulmonary artery pressure with echocardiogram showed clinically significant reductions in PH. Five patients (20%) died during the follow-up period. Adverse events leading to cessation or interruption of therapy occurred in 2 patients, I for recurrent erections, and the other had the medication held briefly because of intestinal pneumatosis. Conclusion These data suggest that chronic sildenafil therapy is well-tolerated, safe. and effective for infants with PH and CLD. (J Pediatr 2009;154:379-60)
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