Document Detail


Phosphodiesterase inhibitors for persistent pulmonary hypertension of the newborn: a review.
MedLine Citation:
PMID:  14618646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Persistent pulmonary hypertension of the newborn (PPHN) is a complex syndrome with multiple causes, with an incidence of 0.43-6.8/1,000 live births and a mortality of 10-20%. Survivors have high morbidity in the forms of neurodevelopmental and audiological impairment, cognitive delays, hearing loss, and a high rate of rehospitalization. The optimal approach to the management of PPHN remains controversial. Inhaled nitric oxide (iNO) is currently regarded as the gold standard therapy, but with as many as 30% of cases failing to respond, has not proven to be the single magic bullet. Given the complex pathophysiology of the disease, any such magic bullet is unlikely. A number of recent studies have suggested a role for specific phosphodiesterase (PDE) inhibitors in the management of PPHN. Sildenafil, a specific PDE5 inhibitor, appears the most promising of such agents. We aim to review the current status and limitations of iNO and the potential of PDE inhibitors in the management of PPHN. The reasons why caution is warranted before specific PDE5 inhibitors like sildenafil are labelled as potential magic bullets for PPHN will be discussed. The need for randomized-controlled trials to determine the safety, efficacy, and long-term outcome following treatment with sildenafil in PPHN is emphasized.
Authors:
J N Travadi; S K Patole
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  36     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-11-17     Completed Date:  2004-04-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  529-35     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Dipyridamole / therapeutic use
Endothelium-Dependent Relaxing Factors / therapeutic use
Humans
Infant, Newborn
Nitric Oxide / therapeutic use
Pentoxifylline / therapeutic use
Persistent Fetal Circulation Syndrome / drug therapy*,  physiopathology
Phosphodiesterase Inhibitors / therapeutic use*
Phosphoric Diester Hydrolases / physiology
Piperazines / therapeutic use
Purines
Purinones / therapeutic use
Sulfones
Chemical
Reg. No./Substance:
0/Endothelium-Dependent Relaxing Factors; 0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Purinones; 0/Sulfones; 10102-43-9/Nitric Oxide; 139755-83-2/sildenafil; 37762-06-4/zaprinast; 58-32-2/Dipyridamole; 6493-05-6/Pentoxifylline; EC 3.1.4.-/Phosphoric Diester Hydrolases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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