The Effect of Oral Sildenafil on the Decrease in the Degree of Pulmonary Artery Systolic Pressure in PPHN Infants at Siti Khodijah Muhammadiyah Hospital Sepanjang

Muhammad Afif(1*), Muhammad Perdana Airlangga(2), Nurma Yuliyanasari(3), Gina Noor Djalilah(4)


(1) Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(2) Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(3) Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(4) Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(*) Corresponding Author

Abstract


Background: Persistent Pulmonary Hypertension of the Newborn (PPHN) is a condition of the failure to decrease pulmonary artery pressure, so that blood pressure in the lungs remains high, as in a fetus. PPHN cases are 2-6 of 1000 live births and responsible for 10% of confirmed deaths in the neonatal intensive care unit (NICU). Sildenafil is vasodilator that can be used to reduce pulmonary artery systolic pressure (PASP), morbidity, and mortality in PPHN infants.

Objective: To analyze the effect of sildenafil on decrease the severity of pulmonary artery systolic pressure in PPHN infants.

Method: This is an analytic observational study with cross-sectional design. The samples were collected using consecutive sampling on 30 PPHN infant patients in 2018. The data were collected from medical records of PPHN infant patients, then assessing the severity value of PASP which obtained from echocardiography result. The severity of PASP is classified into normal (PASP≤35 mmHg), mild (PASP36-45 mmHg), moderate (PASP 45-60 mmHg), and severe (PASP>60 mmHg)

Results: This study showed that 27 PPHN infant patients have decreased PASP level to normal, previously from mild 7 infants (23.3%), moderate 16 infants (53.3%), and severe 4 infants (13%), after being given oral sildenafil. There were 1 (3.3%) infant patient remained severes, 1 (3.3%) patient was decreased from severe to moderate, and 1 patient (3.3%) was decreased from severe to mild. The p value <0.05 was obtained, so oral sildenafil significantly decreased the PASP severity in PPHN infants patients.

Conclusion: There is a beneficial effect of oral sildenafil on decreasing the severity of pulmonary artery systolic pressure in PPHN infants at the NICU of Siti Khodijah Muhammadiyah Hospital Sepanjang.


Keywords


Severity PASP, oral sildenafil, PPHN

Full Text:

PDF

References


Ontoseno T. Penyakit jantung pada anak. Jakarta: Sagung Seto; 2018.

Kang C, Zhao E, Zhou Y, Zhao H, Liu Y, Gao N, et al. Dynamic changes of pulmonary arterial pressure and ductus arteriosus in human newborns from birth to 72 hours of age. Medicine (Baltimore). 2016;95(3).

Prithviraj D, Reddy B, Shetty A, Deepthi, Reddy R. Oral Sildenafil in Persistent Pulmonary Hypertension of the Newborn in Invasive and Non-invasive Ventilated Babies-its Effect on Oxygenation Indices. Int J Sci STUDY. 2016;4(2):203–9.

Hussain AS, Ali R, Ahmed S, Naz F, Haroon A. Oral sildenafil use in neonates with persistent pulmonary hypertension of newborn. J Ayub Med Coll Abbottabad. 2017;29(4):677–80.

Lasmono SF. Efikasi Dan Safety Beraprost Dalam Menurunkan Tekanan Arteri Pulmonalis Pada Hipertensi Arteri Pulmonalis Terkait Penyakit Jantung Bawaan Pirau Kiri Ke Kanan. Universitas Airlangga; 2018.

Bendapudi P, Rao GG, Greenough A. Diagnosis and management of persistent pulmonary hypertension of the newborn. Paediatr Respir Rev. 2015 Jun;16(3):157–61.

Main ML, Grayburn PA, Lang RM, Goldman JH, Gibson CM, Sherwin P, et al. Effect of Optison on pulmonary artery systolic pressure and pulmonary vascular resistance. Am J Cardiol. 2013;112(10):1657–61.

Merlos P, Núñez J, Sanchis J, Miñana G, Palau P, Bodí V, et al. Echocardiographic estimation of pulmonary arterial systolic pressure in acute heart failure. Prognostic implications. Eur J Intern Med. 2013;24(6):562–7.

Susanto LTM. Sildenafil dalam penatalaksanaan disfungsi ereksi. Susanto, Bagian Histol Fak Kedokt Univ Trisakti. 2013;

Koentartiwi D. Efek sildenafil pada hipertensi paru sekunder akibat penyakit jantung bawaan lesi pirau kiri ke kanan= Sildenafil for secondary pulmonary hypertension due to left to right shunt. 2014;

Dodgen AL, Hill KD. Safety and tolerability considerations in the use of sildenafil for children with pulmonary arterial hypertension. Drug Healthc Patient Saf. 2015;7:175.

Harerimana I, Ballot DE, Cooper PA. Retrospective review of neonates with persistent pulmonary hypertension of the newborn at Charlotte Maxeke Johannesburg Academic Hospital. South African J Child Heal. 2018;12(1):29–33.

Manes A, Palazzini M, Dardi F, D’Adamo A, Rinaldi A, Galiè N. Female gender and pulmonary arterial hypertension: a complex relationship. G Ital Cardiol (Rome). 2012;13(6):448.

Begum NA, Afroze S, Laila R, Siddiqua SP, Rahaman MT. Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. Am J Pediatr. 2019;5(3):142–7.

Al-lawama M, Badran E, Abdelfattah AS, Jaddalla R, Almahameed HA, Al-Ammouri I. Outcomes of newborn infants with pulmonary hypertension treated with oral sildenafil in a tertiary care center in Amman, Jordan. Int J Clin Pediatr. 2019;8(2):27–31.

Babooa N, Shi W-J, Chen C. Factors relating caesarean section to persistent pulmonary hypertension of the newborn. World J Pediatr. 2017;13(6):517–27.

Anas M, Triastuti N, Airlangga MP. Role Of Inhaled Nitric Oxides In Pregnancy With Eisenmenger Syndrome. Qanun Med J Fac Med Muhammadiyah Surabaya. 2020;4(1):11–26.

Agha H, El Tantawy A, Iskander I, Samad AA. Impact of Management Strategies on the Outcome of Persistent Pulmonary Hypertension of the Newborn. Fortune Journals. 2017;

Shrestha SK, Srivastava B, Karki M, Khatri DB, Pradhan RM. Effect of sildenafil citrate on pulmonary arterial systolic pressure and sub-maximal exercise capacity in chronic obstructive pulmonary disease. Kathmandu Univ Med J. 2017;15:271–8.

Mathew B, Lakshminrusimha S. Persistent pulmonary hypertension in the newborn. Children. 2017;4(8):63.

Rocha G, Baptista MJ, Guimarães H. Persistent pulmonary hypertension of non cardiac cause in a neonatal intensive care unit. Pulm Med. 2012;2012.

Espinola-Zavaleta N, Soto ME, Romero-Gonzalez A, Gómez-Puente L del C, Muñoz-Castellanos L, Gopal AS, et al. Prevalence of congenital heart disease and pulmonary hypertension in Down’s syndrome: an echocardiographic study. J Cardiovasc Ultrasound. 2015;23(2):72–7.

Anas M, Marlina U. Penggunaan Nitrovasodilator Sebagai Donor Oksida Nitrik Pada Preeklamsia. In: PROCEEDING. 2018.

Triastuti N, Airlangga MP, Anas M. Usage of Inhaled Nitric Oxides in Cases of Eisenmenger Syndrome. Indones J Med Sci Public Heal. 2020;1(1):13–9.

Zeng W, Lu X, Xiong C, Shan G, Liu Z, Ni X, et al. The efficacy and safety of sildenafil in patients with pulmonary arterial hypertension associated with the different types of congenital heart disease. Clin Cardiol. 2011;34(8):513–8.


Article Metrics

Abstract view : 789 times
PDF - 119 times

DOI: https://doi.org/10.26714/magnamed.8.1.2021.18-28

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Indexed by

 

      

 

Creative Commons License

MAGNA MEDIKA by APKKM is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.