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Oral Sildenafil for Severe Pulmonary Hypertension Developing after Ibuprofen Use in a Neonate

M Jose Rodriguez-Castano1, Esther Aleo, Luis Arruza

  • 1Department of Neonatology, Hospital Clinico San Carlos, Madrid, Spain. Correspondence to: Dr M Jose Rodriguez-Castano, Department of Neonatology Hospital Clinico San Carlos, Profesor Martin Lagos s/n, 28040, Madrid, Spain. mariyou100@hotmail.com.

Indian Pediatrics
|May 10, 2016
PubMed

Insights

Severe pulmonary hypertension in preterm infants may occur after ibuprofen for ductal closure. Oral sildenafil showed potential in reversing this condition, though the infant later died from bronchopulmonary dysplasia complications.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Ibuprofen is commonly used to close patent ductus arteriosus in preterm infants.
  • Severe pulmonary hypertension is a potential complication following ibuprofen administration for ductal closure.
  • This condition can be refractory to standard treatments like inhaled nitric oxide.

Observation:

  • A case study of an extremely preterm infant is presented.
  • The infant developed severe pulmonary hypertension unresponsive to inhaled nitric oxide after ibuprofen treatment.
  • This highlights a critical adverse event in neonatal care.

Findings:

  • Oral sildenafil administration led to the reversal of pulmonary hypertension.
  • Despite the positive effect on pulmonary hypertension, the infant's outcome was poor.
  • The infant ultimately died due to complications associated with bronchopulmonary dysplasia.

Implications:

  • Sildenafil may represent a novel therapeutic option for severe pulmonary hypertension post-ibuprofen treatment.
  • Further research is warranted to explore the efficacy and safety of sildenafil in this context.
  • This case underscores the complex interplay between interventions and outcomes in extremely preterm neonates.
Abstract

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