Related Experiment Video
Updated: Jun 24, 2025
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Prophylactic sildenafil to prevent bronchopulmonary dysplasia: A systematic review and meta-analysis
Katsuya Hirata1, Atsuko Nakahari2, Mami Takeoka3
1Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.
Insights
Prophylactic sildenafil did not prevent bronchopulmonary dysplasia (BPD) or reduce mortality in preterm infants. Early sildenafil administration showed no significant benefits and requires further investigation due to low certainty of evidence.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) is a major cause of death and illness in extremely preterm infants.
- The early use of sildenafil to prevent BPD is not well-established.
- This study evaluated prophylactic sildenafil for preventing mortality and BPD in preterm infants.
Purpose of the Study:
- To determine the efficacy and safety of early prophylactic sildenafil administration.
- To assess the impact of sildenafil on mortality and BPD rates in preterm neonates.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and other study designs.
- Searched multiple databases including MEDLINE, Embase, and Cochrane.
- Assessed risk of bias and certainty of evidence using GRADE guidelines.
Main Results:
- Included three RCTs with 162 infants; no significant differences in mortality or BPD between sildenafil and placebo groups.
- All outcomes showed very low certainty of evidence.
- Sample sizes were insufficient, indicating a need for further research.
Conclusions:
- Prophylactic sildenafil offers no apparent benefits for mortality, BPD, or other outcomes in at-risk infants.
- No increased side effects were observed with prophylactic sildenafil use.
- Further trials are necessary to definitively assess sildenafil's role.
Background:
Bronchopulmonary dysplasia (BPD) persists as one of the foremost factors contributing to mortality and morbidity in extremely preterm infants. The effectiveness of administering sildenafil early on to prevent BPD remains uncertain. The aim of this study was to investigate the efficacy and safety of prophylactically administered sildenafil during the early life stages of preterm infants to prevent mortality and BPD.
Methods:
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Ichushi were searched. Published randomized controlled trials (RCTs), non-RCTs, interrupted time series, cohort studies, case-control studies, and controlled before-and-after studies were included. Two reviewers independently screened the title, abstract, and full text, extracted data, assessed the risk of bias, and evaluated the certainty of evidence (CoE) following the Grading of Recommendations Assessment and Development and Evaluation approach. The random-effects model was used for a meta-analysis of RCTs.
Results:
This review included three RCTs (162 infants). There were no significant differences between the prophylactic sildenafil and placebo groups in mortality (risk ratio [RR]: 1.32; 95% confidence interval [CI]: 0.16-10.75; very low CoE), BPD (RR: 1.20; 95% CI: 0.79-1.83; very low CoE), and all other outcome assessed (all with very low CoE). The sample sizes were less than the optimal sizes for all outcomes assessed, indicating the need for further trials.
Conclusions:
The prophylactic use of sildenafil in individuals at risk of BPD did not indicate any advantageous effects in terms of mortality, BPD, and other outcomes, or increased side effects.
More Related Videos
Related Concept Videos
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
01:05Breathing
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment