Efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension in children：a preliminary evaluation
XIA Yan-Liang1, YAN Wei-Xiao1, CHEN Hong2
Intensive Care Unit, Qinghai Provincial Women's and Children's Hospital, Xining 810007, China
Abstract：Objective To observe the clinical efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension (PAH) in children. Methods Fifty children (aged 2 months to 2 years) with high altitude heart disease associated with severe PAH, who were continuously transferred to the Intensive Care Unit between January 2011 and October 2013, were randomly assigned to observation and control groups. The control group was given conventional treatment, while the observation group received oral sildenafil [1 mg/(kg·d)] three times daily for 7-10 days in addition to the conventional treatment. Before and after treatment, hemodynamics, blood gas, routine blood parameters, and blood biochemical parameters were recorded. Results After treatment, the observation group had a significantly higher decrease in mean pulmonary artery pressure and significantly higher increases in arterial partial pressure of oxygen, cardiac output, cardiac index, and oxygenation index compared with the control group (PP>0.05), and no obvious adverse reactions were found. Conclusions For children with high altitude heart disease associated with severe PAH, sildenafil can effectively reduce pulmonary artery pressure and improve cardiac function and does not cause adverse reactions. This therapy has good safety according to the preliminary evaluation.
XIA Yan-Liang,YAN Wei-Xiao,CHEN Hong. Efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension in children：a preliminary evaluation[J]. CJCP, 2014, 16(7): 745-748.
Haworth SG, Hislop AA. Treatment and survival in children with pulmonary arterial hytertention: the UK Pulmonary Hypertension Srvice for Children 2001-2006[J]. Heart, 2009, 95(3): 312-317.
[9]
Peiravian F, Amirghofran AA, Borzouee M, et a1. Oral sildenafil to control pulmonary hypertension after congenital heart surgery[J]. Asian Cardiovasc Thorac Ann, 2007, 15(2): 113-1l7.
[10]
Namachivayam P, Theilen U, Butt WW, et a1. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children[J]. Am J Respir Crit Care Med, 2006, 174(9): 1042-1047.
