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 Printable version |
Use of sildenafil in secondary pulmonary arterial hypertension in paediatrics: experience in 31 children |
Journal de Pharmacie Clinique. Volume 25, Number 4, 217-23, Décembre 2006, Article original
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 Résumé
Article gratuit
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Author(s) : C Blatrie, E Bezian, M-C Desroches, P Mauriat, T Liautaud, O Corriol, E Singlas |
Summary : Pulmonary arterial hypertension remains a major cause of morbidity after cardiac surgery. Among new pulmonary vasodilators, sildenafil has recently obtained the new drug authorization in this indication for adults (October 2005). The goal of this study was to assess the effectiveness and tolerance of sildenafil per os in secondary forms of pulmonary hypertension. Thirty one children (average age 2.8 years\; sex ratio M/F 1.4) were hospitalised between 2001 and 2005 at Necker hospital in the intensive care unit of the paediatric cardiac surgery unit. The effectiveness of sildenafil was mainly assessed according to final weaning or not from nitric oxide. At the beginning of sildenafil treatment, a continuous monitoring of the pulmonary-artery pressure was effected to obtain an haemodynamic stability and to adapt the dose. During the clinical evaluation, sildenafil was administrated after an extemporaneous dissolution of a Viagra
® tablet. Weaning was possible in 88% of children treated by nitric oxide and sildenafil with an average duration of gas use of 11.4 ± 10.1 days and of NOi/sildenafil co-prescription of 5.1 ± 3.7 days. All the children were treated by NOi and/or sildenafil with an average initial dose of 8.0 ± 4.5 mg/kg/day, generally in 6 times per day. The results showed a large inter-individual variability. Sildenafil had a dose-dependant action on the pulmonary artery-pressure, without correlation with the aetiology. It presented a well tolerance. Sildenafil per os seems an effective alternative to NOi in secondary pulmonary hypertension in paediatrics because it allows weaning from NOi for hospitalised children, and therefore outpatient treatment. |
Keywords : secondary pulmonary arterial hypertension, paediatrics, sildenafil |
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