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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Pediatr+Pharmacol+Ther
2018 ; 23
(2
): 100-105
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A Retrospective Review of Infants Receiving Sildenafil
#MMPMID29720910
De A
; Shah P
; Szmuszkovicz J
; Bhombal S
; Azen S
; Kato RM
J Pediatr Pharmacol Ther
2018[Mar]; 23
(2
): 100-105
PMID29720910
show ga
OBJECTIVE: The purpose of the study was to assess mortality in an infant
population receiving sildenafil. METHODS: A retrospective review of hospitalized
infants at Children's Hospital Los Angeles who received sildenafil between 2008
and 2012 was conducted. Patient characteristics, comorbidities, and treatment
characteristics were analyzed. Primary outcome was mortality at discharge.
Sildenafil dosage ranges were based on the Sildenafil in Treatment-Naïve
Children, Aged 1-17 Years, With Pulmonary Arterial Hypertension trial and were
categorized as small (<1.5 mg/kg/day), medium (1.5-3.75 mg/kg/day), large
(3.76-7.5 mg/kg/day), and very large (>7.5 mg/kg/day). RESULTS: A total of 147
infants were studied. A total of 82% of patients had severe pulmonary
hypertension. Our data revealed 29% mortality at discharge. Mortality increased
with increasing sildenafil dosage: 14% (small), 19% (medium), 49% (large), and
90% (very large). On multivariate analysis of sildenafil dosage, other pulmonary
hypertension therapies, presence of persistent cardiac shunts, and duration of
sildenafil, odds of dying were significantly higher with combined high and very
high sildenafil dosage groups compared with combined low and medium dosage groups
(OR, 13.2; CI, 4.4-39.5; p < 0.0001). CONCLUSION: Sildenafil was given to
critically ill infants with multiple risk factors for mortality. Although higher
doses cannot be causally related to mortality, there appears to be no added
benefit by escalating the sildenafil dose.