Efficacy and Safety of Milrinone versus Sildenafil in the Treatment of Neonates with Persistent Pulmonary Hypertension

Abstract

As Pulmonary hypertension in newborn is a critical problem facing pediatric cardiologists and neonatologists. It is a neonatal emergency due to failure to achieve normal cardiopulmonary adaptation following delivery, one of the most important issues is to improve oxygenation and lower pulmonary artery pressure with adequate support of hemodynamic status and subsequently relieve hypoxemia. The effect of milrinone therapy has not been adequately studied in neonates with oxygenation failure secondary to pulmonary hypertension. The study was conducted on 40 neonates with the diagnosis of PPHN, they were randomly divided into two groups each includes 20 neonates, the first group received intravenous milrinone infusion whereas the second group received nasogastric sildenafil, aiming to shed light on the effect of milrinone and sildenafil in management of PPHN . The analysis of the current study revealed that both milrinone and were effectively improved pulmonary artery pressure, oxygenation index and acid-base balance.

To our knowledge, this is the first study to compare the effects of nasogastric sildenafil and milrinone infusion as a treatment in neonates with PPHN. We proved that milrinone has the superiority above sildenafil as it had much lower OI, PAP with a satisfactory hemodynamic support and lower ventilator parameters were needed with shorter duration of hospitalization.