A comparison of magnesium sulphate and sildenafil in the treatment of the newborns with persistent pulmonary hypertension: a randomized controlled trial.

Sinan Uslu, Soner Kumtepe, Ali Bulbul, Serdar Comert, Fatih Bolat, Asiye Nuhoglu

Journal: Journal of tropical pediatrics 2011;57(4):245-50

PMID: 20923790

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Abstract

The aim of this prospective, randomized and controlled study was to compare the clinical efficacy of intravenous magnesium sulfate (MgSO₄) and oral sildenafil therapies with persistent pulmonary hypertension of the newborn. A total of 34 infants in the MgSO₄ group and 31 infants in the sildenafil group completed the study. The time to reach the adequate clinical response [defined as oxygen index (OI) level of <15, a pulmonary artery pressure of < 20 mmHg) was significantly shorter in the sildenafil group (p = 0.002). Duration of mechanical ventilation was longer and the number of the patients requiring inotropic support was higher in the MgSO₄ group (p = 0.001 and p = 0.002, respectively). Although among two groups the difference in OI > 5 as speculated in our hypothesis could only be found at 36 h of the treatment, sildenafil was more effective than MgSO₄ in the treatment of persistent pulmonary hypertension of the newborns with regard to time to adequate clinical response, duration of mechanical ventilation and support requirement with inotropic agents.

Address: Department of Pediatrics, Division of Neonatology, Sisli Children Hospital, Istanbul, Turkey. [email protected]

DOI: 10.1093/tropej/fmq091

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MeSH Terms: Administration, Oral, Female, Humans, Hypertension, Pulmonary, Infant, Newborn, Injections, Intravenous, Intensive Care Units, Magnesium Sulfate, Male, Oxygen, Persistent Fetal Circulation Syndrome, Piperazines, Prospective Studies, Purines, Respiration, Artificial, Sildenafil Citrate, Sulfones, Treatment Outcome, Vasodilator Agents