title: Post-op sildenafil in infants after cardiac surgery
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  Post-op sildenafil in infants after cardiac surgery
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  bet | 556/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Post-op sildenafil in infants after cardiac surgery
  Stocker et al11 performed an RCT in 16 ventilated infants early after closure of ventricular or atrioventricular septal defects. They were randomly assigned to one of two groups. Seven infants received iNO (20 ppm) first, with the addition of intravenous sildenafil (0.35 mg/kg over 20 min) after 20 min. Eight infants received sildenafil first, iNO was added after 20 min. Intravenous sildenafil augmented the pulmonary vasodilator effects of iNO in infants early after cardiac surgery. However, sildenafil produced systemic hypotension and impaired oxygenation, which was not improved by iNO. Sildenafil is not recommended for this particular indication.
  The European Paediatric Pulmonary Vascular Disease Network Consensus 20167: Beneficial haemodynamic effects of sildenafil have also been demonstrated in failing Fontan circulations. Sildenafil improved max. oxygen consumption (VO2 max.) and pulmonary blood flow in patients with Fontan circulation. Another randomised, crossover study showed that sildenafil therapy improved exercise tolerance and ventilatory efficiency in Fontan patients.
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