Skip to main content

Advertisement

SpringerLink
Log in

Perinatal/Neonatal Case Presentation

Arterial hypotension and prerenal failure in an extremely preterm infant associated with oral sildenafil

  • Perinatal/Neonatal Case Presentation
  • Published:
Journal of Perinatology Submit manuscript

Abstract

We report significant hypotension and prerenal failure in an extremely preterm infant following two doses of oral sildenafil that warranted discontinuation of the drug and treatment with inotropes. Blood pressure and urine output normalized after 24 h of withdrawal of the oral drug. Sildenafil should be used cautiously in extremely preterm infants early in the neonatal course, where there is limited data on its efficacy and safety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Shah PS, Ohlsson A . Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev 2011; 10: CD005494.

    Google Scholar 

  2. Cavallaro G, Agazzani E, Andaloro L, Bottura C, Cristofori G, Mussini P et al. [Sildenafil and nitric oxide inhalation in neonatal pulmonary hypertension. Three case reports]. Pediatr Med Chir 2008; 30: 149–155.

    CAS  PubMed  Google Scholar 

  3. Namachivayam P, Theilen U, Butt WW, Cooper SM, Penny DJ, Shekerdemian LS . Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med 2006; 174: 1042–1047.

    Article  CAS  Google Scholar 

  4. Konig K, Barfield CP, Guy KJ, Drew SM, Andersen CC . The effect of sildenafil on evolving bronchopulmonary dysplasia in extremely preterm infants: a randomised controlled pilot study. J Matern Fetal Neonatal Med 2014; 27: 439–444.

    Article  Google Scholar 

  5. Barst RJ, Beghetti M, Pulido T, Layton G, Konourina I, Zhang M et al. STARTS-2: long-term survival with oral sildenafil monotherapy in treatment-naive pediatric pulmonary arterial hypertension. Circulation 2014; 129: 1914–1923.

    Article  CAS  Google Scholar 

  6. Mukherjee A, Dombi T, Wittke B, Lalonde R . Population pharmacokinetics of sildenafil in term neonates: evidence of rapid maturation of metabolic clearance in the early postnatal period. Clin Pharmacol Ther 2009; 85: 56–63.

    Article  CAS  Google Scholar 

  7. Ahsman MJ, Witjes BC, Wildschut ED, Sluiter I, Vulto AG, Tibboel D et al. Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube. Arch Dis Child Fetal Neonatal Ed 2010; 95: F109–F114.

    Article  Google Scholar 

  8. Wardle AJ, Wardle R, Luyt K, Tulloh R . The utility of sildenafil in pulmonary hypertension: a focus on bronchopulmonary dysplasia. Arch Dis Child 2013; 98: 613–617.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neonatal Clinical Care Unit, King Edward Memorial Hospital for Women, Perth, WA, Australia

    H Balasubramanian, T Strunk & R Kohan

  2. Centre for Neonatal Research and Education, School of Paediatrics and Child Health University of Western Australia, Perth, WA, Australia

    T Strunk & R Kohan

Authors
  1. H Balasubramanian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Strunk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Kohan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H Balasubramanian.

Ethics declarations

Competing interests

The authors declare no conflict of interest

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balasubramanian, H., Strunk, T. & Kohan, R. Arterial hypotension and prerenal failure in an extremely preterm infant associated with oral sildenafil. J Perinatol 35, 458–459 (2015). https://doi.org/10.1038/jp.2015.31

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2015.31

  • Springer Nature America, Inc.

This article is cited by

Search

Navigation