Friday, November 03, 2006

Wow, I guess they are starting younger

Viagra For Babies? Sildenafil Found To Prevent Rebound Pulmonary Hypertension In Infants


This is too good to pass up, even if it is a bit creepy. "Rebound Pulmonary Hypertension" occurs after infants in the ICU come off inhaled nitric oxide treatment and it seems that a single dose of sidenafil (also sold as Viagra) solves the problem.

From ScienceDirect

A single dose of sildenafil, a
blood vessel widening vasodilator (also sold under the brand name
Viagra), prevented rebound pulmonary hypertension and significantly
reduced the duration of mechanical ventilation in intensive care unit
(ICU) infants being withdrawn from inhaled nitric oxide therapy.





This research appears in the first issue for
November 2006 of the American Journal of Respiratory and Critical Care
Medicine, published by the American Thoracic Society.

Lara
Shekerdemian, M.D., of the Pediatric Intensive Care Unit at the Royal
Children's Hospital in Melbourne, Australia, and five associates gave a
single dose of sildenafil to 15 infants undergoing withdrawal from
inhaled nitric oxide therapy. None experienced rebound pulmonary
hypertension, a common therapeutic complication.

Fourteen
children in the study cohort received a placebo. Ten of the 14 had an
acute elevation of pulmonary artery pressure by 20 percent or more
during the latter part of the weaning process.

Inhaled nitric
oxide was first introduced in the early 1990s as a therapeutic agent to
widen pulmonary blood vessels in ventilated lung regions by relaxing
pulmonary vascular smooth muscle.

Although there have been no
definitive studies of clinical benefit to date, the investigators
believe that inhaled nitric oxide therapy warrants use as an adjunctive
treatment in some of the sickest patients in the ICU. They call it
"unrivaled" in its efficacy as a selective pulmonary vasodilator.

"An
important complication that is associated with the use of inhaled
nitric oxide is the development of rebound pulmonary hypertension on
its withdrawal," said Dr. Shekerdemian.

All infants who failed to
respond were given sildenafil during a subsequent weaning attempt more
than 24 hours later and were weaned successfully from nitric oxide
treatment.

The total duration of ventilation for patients given
sildenafil was slightly over 28 hours, as compared with 98 hours for
those taking a placebo.

"The total ICU stay after the study was
completed was 47.8 hours for the sildenafil group and 189 hours for the
placebo group," added Dr. Shekerdemian.

"This study is unique in
a number of ways," she continued. "It is the first study to investigate
the pharmacologic prophylaxis of rebound pulmonary hypertension during
the primary attempt to wean from inhaled nitric oxide. This is also the
first prospective trial of sildenafil in the prevention of rebound
pulmonary hypertension. Moreover, this study is the first that defines
the extent of the problem of rebound pulmonary hypertension in infants
and children weaning from inhaled nitric oxide in the pediatric ICU."

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