Use of oral sildenafil to facilitate weaning from inhaled nitric oxide following congenital heart surgery: Our clinical experiences Doǧuştan kalp cerrahisi sonrası inhale nitrik oksit tedavisinin kesilmesine yardımcı oral sildenafil kullanımı: Klinik deneyimlerimiz
Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.19, sa.4, ss.518-523, 2011 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 19 Sayı: 4
- Basım Tarihi: 2011
- Doi Numarası: 10.5606/tgkdc.dergisi.2011.080
- Dergi Adı: Turkish Journal of Thoracic and Cardiovascular Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.518-523
- Anahtar Kelimeler: Congenital heart surgery, nitric oxide, rebound pulmonary hypertension, sildenafil
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: This study aims to evaluate the results of the prophylactic use of oral sildenafil in weaning from inhaled nitric oxide (iNO) treatment following congenital cardiac surgery in severe pulmonary hypertensive patients. Methods: Oral sildenafil (1 mg/kg, 4 times daily) was added to the treatment of 18 of 21 patients who had started iNO therapy intraoperatively, on the postoperative first day. The medical records of the patients were retrospectively evaluated with respect to the clinical status of rebound pulmonary artery hypertension, entubation time, duration of intensive care unit stay, and early and late mortality. Results: Early mortality was seen in four (22.2%) of 18 patients with the sildenafil treatment protocol. Two (11.1%) deaths were due to low cardiac output on the postoperative first day, and the remaining two (11.1%) deaths were due to severe rebound pulmonary hypertensive crisis on the postoperative sixth and ninth days. In 14 (77.8%) of the patients, no rebound pulmonary hypertensive crisis was seen after the discontinuation of iNO with the oral sildenafil treatment. Conclusion: The prophylactic use of sildenafil to facilitate iNO withdrawal can be beneficial in the prevention of rebound pulmonary hypertension following congenital cardiac surgery. Randomized controlled trials are needed to evaluate the safety and efficacy of the prophylactic use.