| Postoperative use of oral sildenafil in pediatric patients with congenital heart disease. | |
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MedLine Citation:
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PMID: 20054528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We sought to determine the efficacy of postoperative oral sildenafil therapy (OST) in pediatric patients with congenital heart disease (CHD). A retrospective review of 45 postoperative patients with CHD who received OST was performed. Patients were categorized into three groups according to clinical indications: (1) to stabilize pulmonary vascular reactivity after biventricular repair (group 1 [n = 15]), (2) to lower pulmonary vascular resistance after bidirectional cavopulmonary shunt (group 2 [n = 12]), and (3) to improve post-Fontan hemodynamics (group 3 [n = 18]). Thirty-four patients (34 of 45 [75.6%]) had received inhaled nitric oxide (iNO) while on OST. Mean pulmonary arterial pressure (mPAP), mean systemic blood pressure (mSBP), and peripheral oxygen saturation (SpO(2)) were recorded during the first 24 hours after the initiation of OST. In group 1, the baseline mPAP/mSBP ratio (0.60 +/- 0.17) decreased significantly after the second (0.46 +/- 0.14, p = 0.004) and fourth (0.50 +/- 0.18, p = 0.025) doses of OST. In group 2, baseline SpO(2) (71.0 +/- 12.3%) increased after the fourth dose (75.1 +/- 12.3%, p = 0.04) of OST, without significant changes in mPAP. In group 3, baseline mPAP (14.8 +/- 3.3 mmHg) decreased significantly after the first (13.9 +/- 2.8 mmHg, p = 0.025) and second (13.3 +/- 1.9 mmHg, p = 0.016) doses of OST, without changes in SpO(2). In thirty-one (31 of 34 [92%]) subjects, iNO was discontinued within a median of 2 days after the initiation of OST, without rebound phenomena. There were no OST-related complications. Sildenafil citrate can be used safely in postoperative pediatric patients with CHD. Benefits from OST may be manifested differently in various clinical settings. |
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Authors:
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Ju Yeon Uhm; Won-Kyoung Jhang; Jeong-Jun Park; Dong-Man Seo; Sung-Cheol Yun; Tae-Jin Yun |
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Publication Detail:
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Type: Journal Article Date: 2010-01-07 |
Journal Detail:
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Title: Pediatric cardiology Volume: 31 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-23 Completed Date: 2010-08-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 515-20 Citation Subset: IM |
Affiliation:
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Division of Pediatric Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Ku, Seoul 138-736, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Administration, Oral Adolescent Blood Pressure / drug effects Child Child, Preschool Drug Therapy, Combination Female Heart Defects, Congenital / surgery* Hemodynamics / drug effects Humans Infant Infant, Newborn Male Nitric Oxide / administration & dosage Oxygen / blood Piperazines / administration & dosage*, adverse effects Postoperative Complications / drug therapy* Pulmonary Artery / drug effects Pulmonary Wedge Pressure / drug effects Purines / administration & dosage, adverse effects Retrospective Studies Sulfones / administration & dosage*, adverse effects Treatment Outcome Vascular Resistance / drug effects Vasodilator Agents / administration & dosage*, adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 10102-43-9/Nitric Oxide; 139755-83-2/sildenafil; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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