Oral sildenafil therapy for the management of mild persistent pulmonary hypertension of the newborn in term neonates

Abstract

The use of sildenafil leads to an improvement in oxygenation and has the potential to reduce mortality in severe persistent pulmonary hypertension of neonates (PPHN). Mild PPHN in term neonates often prolongs the duration of oxygen requirement without other major morbidities, thereby increasing the length of hospital stay. We present a case series of eight term neonates with clinical and echocardiographic evidence of mild PPHN, in whom treatment with oral sildenafil resulted in early clinical improvement. It was observed that neonates could be weaned off from oxygen inhalation after a mean (SD) 53.1 (11.8) h of starting oral sildenafil as their oxygen saturation was maintained between 93 and 95% in room air. Infants could be discharged home after a median (IQR) 10 (7.5–12) days and oral sildenafil could be stopped after a median duration of 1.4 (1–1.8) months. All infants tolerated oral sildenafil well without any major adverse events.