European Journal of Pediatrics

, Volume 164, Issue 10, pp 626–629 | Cite as

Severe persistent pulmonary hypertension of the newborn in a setting where limited resources exclude the use of inhaled nitric oxide: successful treatment with sildenafil

Original Paper

Abstract

We present the case of a full term neonate with severe persistent pulmonary hypertension of the newborn (PPHN) after birth asphyxia cared for at the St. Elizabeth Hospital in Curacao, Netherlands Antilles. Although the child was ventilated with high pressures and was given high doses of cardiovascular pressors, the arterial oxygen levels remained low with an alveolar-arterial O2 gradient of 651 mmHg. As a last resort, sildenafil (1.5 mg/kg) was given via a nasogastric tube. This resulted in an immediate and sustained elevation of arterial oxygenation and subsequent complete recovery. After administration of sildenafil there was a transient hypotension which was corrected by a single bolus of saline. Conclusion:We discuss the current treatment modalities of persistent pulmonary hypertension of the newborn and the potential use of phosphodiesterase 5 inhibitors such as sildenafil in a situation where the standard of practice with inhaled nitric oxide and extracorporeal membrane oxygenation is not available.

Keywords

Persistent pulmonary hypertension of the newborn Sildenafil 

Abbreviations

ECMO

extracorporeal membrane oxygenation

iNO

inhaled nitric oxide

PDE

phosphodiesterase

PPHN

persistent pulmonary hypertension of the newborn

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Delfzicht ZiekenhuisDelfzijl The Netherlands
  2. 2.St. Elizabeth HospitalWillemstad Curacao, Netherlands Antilles

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