Int J Clin Pediatr

International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access

Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc

Journal website http://www.theijcp.org

Original Article

Volume 8, Number 2, October 2019, pages 27-31

Outcomes of Newborn Infants With Pulmonary Hypertension Treated With Oral Sildenafil

**Table 1.** Demographic Characteristics of Patients With Pulmonary Hypertension Who Received Sildenafil Treatment
Characteristics
SD: standard deviation.
Mean gestational age (range), weeks	36 (28 - 40)
Cesarean section, N (%)	18 (66.7)
Male gender, N (%)	17 (63.0)
Birth weight, mean ± SD, g	2,800 ± 467
Small for age, N (%)	4 (14.8)
Apgar score
First min (mean)	6
Fifth min (mean)	8
Intubation at delivery room, N (%)	9 (33.3)
Maternal age (mean), years	29
Maternal disease, N (%)
Hypertension	1 (3.7)
Thrombophilia	4 (14.4)
Chorioamnionitis	1 (3.7)
Prolonged rupture of membranes	4 (14.4)

Table 1. Demographic Characteristics of Patients With Pulmonary Hypertension Who Received Sildenafil Treatment

Characteristics

SD: standard deviation.

Mean gestational age (range), weeks

36 (28 - 40)

Cesarean section, N (%)

18 (66.7)

Male gender, N (%)

17 (63.0)

Birth weight, mean ± SD, g

2,800 ± 467

Small for age, N (%)

4 (14.8)

Apgar score

First min (mean)

Fifth min (mean)

Intubation at delivery room, N (%)

9 (33.3)

Maternal age (mean), years

Maternal disease, N (%)

Hypertension

1 (3.7)

Thrombophilia

4 (14.4)

Chorioamnionitis

1 (3.7)

Prolonged rupture of membranes

4 (14.4)

**Table 2.** Original Disease in Neonates With Pulmonary Hypertension
Original disease	N (%)
RDS: respiratory distress syndrome; MAS: meconium aspiration syndrome; HIE: hypoxic ischemic encephalopathy; CHD: congenital heart disease.
RDS	10 (37.0)
Diaphragmatic hernia	5 (18.5)
MAS	4 (14.8)
Congenital pneumonia	2 (7.4)
HIE	2 (7.4)
CHD	2 (7.4)
Sepsis	1 (3.7)
Air leak	1 (3.7)

Table 2. Original Disease in Neonates With Pulmonary Hypertension

Original disease

N (%)

RDS: respiratory distress syndrome; MAS: meconium aspiration syndrome; HIE: hypoxic ischemic encephalopathy; CHD: congenital heart disease.

RDS

10 (37.0)

Diaphragmatic hernia

5 (18.5)

MAS

4 (14.8)

Congenital pneumonia

2 (7.4)

HIE

2 (7.4)

CHD

2 (7.4)

Sepsis

1 (3.7)

Air leak

1 (3.7)

**Table 3.** Clinical and Outcome Data of Neonates With Pulmonary Hypertension Treated With Oral Sildenafil
Character	N (%)
^aMean. HFMV: high frequency mechanical ventilation.
Shock at presentation	8 (29.6)
100% O₂ need at presentation	12 (44.4)
Metabolic acidosis at presentation	14 (51.8)
Respiratory distress on day 1	24 (88.9)
Age of clinical diagnosis of (days)	2^a
Age of echo diagnosis of (days)	3^a
Conventional mechanical ventilation	26 (96.2)
HFMV	7 (25.9)
Surfactant	12 (44.44)
Mortality	12 (44.4)

Table 3. Clinical and Outcome Data of Neonates With Pulmonary Hypertension Treated With Oral Sildenafil

Character

N (%)

^aMean. HFMV: high frequency mechanical ventilation.

Shock at presentation

8 (29.6)

100% O₂ need at presentation

12 (44.4)

Metabolic acidosis at presentation

14 (51.8)

Respiratory distress on day 1

24 (88.9)

Age of clinical diagnosis of (days)

2^a

Age of echo diagnosis of (days)

3^a

Conventional mechanical ventilation

26 (96.2)

HFMV

7 (25.9)

Surfactant

12 (44.44)

Mortality

12 (44.4)

**Table 4.** Treatment for Pulmonary Hypertension Offered to Neonates Before and After Sildenafil Treatment
Medication	Pre sildenafil	Post sildenafil	P value
Dopamine	11 (40.75)	16 (59.25)	0.178
Dobutamine	16 (59.25)	23 (85.18)	0.035
Epinephrine	2 (7.4)	4 (14.81)	0.390
MgSO₄	12 (44.4)	14 (51.85)	0.587

Table 4. Treatment for Pulmonary Hypertension Offered to Neonates Before and After Sildenafil Treatment

Medication

Pre sildenafil

Post sildenafil

P value

Dopamine

11 (40.75)

16 (59.25)

0.178

Dobutamine

16 (59.25)

23 (85.18)

0.035

Epinephrine

2 (7.4)

4 (14.81)

0.390

MgSO₄

12 (44.4)

14 (51.85)

0.587

**Table 5.** Comparison Between Survivors and Non-Survivors
Character	Deaths, N (%)	Survivors, N (%)	P value
RDS: respiratory distress syndrome; MAS: meconium aspiration syndrome; CDH: congenital diaphragmatic hernia; C/S: cesarean section; HFMV: high frequency mechanical ventilation; SD: standard deviation.
RDS	5 (42)	5 (33)	0.706
MAS	2 (17)	2 (13)	1.0
CDH	4 (33)	1 (6)	0.139
Intubation at birth	3 (25)	5 (33)	0.695
Birth weight (g), mean ± SD	2,700 ± 529	2,926 ± 384	0.210
Preterm	4 (33)	5 (33)	1.0
C/S	7 (58)	10 (67)	0.706
Male	8 (67)	9 (60)	1.0
Shock	7 (58)	0 (0)	0.0009
HFMV use	5 (42)	2 (13)	0.185

Table 5. Comparison Between Survivors and Non-Survivors

Character

Deaths, N (%)

Survivors, N (%)

P value

RDS: respiratory distress syndrome; MAS: meconium aspiration syndrome; CDH: congenital diaphragmatic hernia; C/S: cesarean section; HFMV: high frequency mechanical ventilation; SD: standard deviation.

RDS

5 (42)

5 (33)

0.706

MAS

2 (17)

2 (13)

1.0

CDH

4 (33)

1 (6)

0.139

Intubation at birth

3 (25)

5 (33)

0.695

Birth weight (g), mean ± SD

2,700 ± 529

2,926 ± 384

0.210

Preterm

4 (33)

5 (33)

1.0

C/S

7 (58)

10 (67)

0.706

Male

8 (67)

9 (60)

1.0

Shock

7 (58)

0 (0)

0.0009

HFMV use

5 (42)

2 (13)

0.185