Dr. Shazia Noureen, Dr. Aneeqa Noor, Dr Muhammad Nida e Hussain
Sildenafil taken vocally is a good prospective solution to the problem but it hasn’t been methodically assessed in babies with PPHN. Every 7 out of 1000 live births experience persistent pulmonary hypertension (PPHN). The rate of deaths is high but is reduced to around 15% with the use of inhalation of nitric oxide, surfactant and ventilation of the high frequency type. Selective decrease in the pulmonary vascular resistance is achieved with Sildenafil, which is a phosphor diesterase in hibitor of kind. The best to treat neonates suffering from hypertension of the pulmonary type is inhalation of nitric oxide including vasodilator of the pulmonary type. Material & methods: in this study and research all that patients who fulfilled the inclusion criteria and visited to lahore general hospital, lahore were included. Informed consent was taken from parents / guardian after explaining the procedure, risks and benefits of the study. Sildenafil tablet (50 mg) was crushed and reconstituted with distilled water and then stored in a plastic container in a refrigerator at 5°c. Oral sildenafil was given as per study protocol with a starting dose of 0.5 mg/kg/dose and increased by 0.5 mg/kg/dose to a maximum of 2 mg/kg/dose after assessing every 6 h if non-responsive. Oi, oxygen saturations (spo), alveolar-arterial oxygen gradient (a-ado2), a/a ratio, and sopi (for non-invasive ventilated babies) were monitored serially every 6 hours. Results: efficacy of oral sildenafil was noted in 208 (78.78%) patents while 56 (21.22%) was found to be non-effective (p-value<0.001*). Mean ± sd of gestational age was 38.5±8.39 with c.i (37.4 to 39.5) weeks. Mean ± sd of birth weight was 3215±348 with c.i (3172.8 to 3257.1) grams. Conclusion: efficacy of oral sildenafil in maintenance of persistent pulmonary hypertension was found to be effective and underscores the need for a large, controlled trial, also to be concluded. Keywords: Oral Sildenafil, Efficacy, Persistent pulmonary Hypertension, Neonates.