Rectal bleeding in extremely preterm infants associated with oral sildenafil therapy: A case series
Abstract
Sildenafil is a highly selective type 5 phosphodiesterase inhibitor, results in an increased level of cyclic guanosine monophosphaten and enhances nitric oxide-mediated vasodilation. The selective vasodilatory effect of sildenafil is a key feature in its use in the treatment of pulmonary hypertension (PH). The role of pulmonary vasodilator therapy in extremely preterm infants is usually limited to PH that is secondary to bronchopulmonary dysplasia that typically occurs at later chronological age. The recommended starting dose for sildenafil is 0.5– 1 mg/kg/dose every 8 h. If there is no evidence of systemic hypotension, this dose can be gradually increased over 2 weeks to achieve desired pulmonary haemodynamic effect or a maximum of 2 mg/kg/dose every 6–8 h. There are concerns regarding shortand long-term safety of sildenafil, especially with high doses, prolonged treatment and administration to preterm infants.
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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