Abstract
Background: Sildenafil (Viagra®) has been shown to be a specific and effective pulmonary vasodilator and is increasingly used in patients with pulmonary hypertension. We investigated the effect of sildenafil medication on cerebral oxygenation using near-infrared spectroscopy (NIRS) in children with elevated pulmonary vascular resistance after cardiac surgery.
Methods: Sildenafil was applied in three steps of 15 minutes each with cumulative doses of 0.1, 0.3 and 0.6 mg/kg. We examined the changes of oxygenated haemoglobin (HbO2), deoxygenated haemoglobin (HHb), total haemoglobin (tHb) concentration and cytochrome oxidase (CytOx) oxygenation and cerebral tissue oxygenation index (TOI) in 13 children.
Results: A significant increase was observed in cerebral O2Hb (Ä 2.3 ± 0.6 ìmol/L; p = 0.02) and tHb (Ä 0.9± 0.2 ìmol/; p = 0.005) at the beginning of intravenous sildenafil administration with a decrease in HHb (Ä −1.3 ìmol/l ± 0.4; p = 0.02). These changes lead to a significant elevation in cerebral TOI from 63.4 ± 2.5 % to 65.7 ± 2.8% (p= 0.01), while mean systemic arterial pressure and arterial oxygen partial pressure tended to decrease.
Conclusion: We conclude that infusion of sildenafil was associated with an increased cerebral haemoglobin and oxygen supply in children after cardiopulmonary bypass surgery. These observations may indicate an increased cerebral blood flow after sildenafil administration.
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Fleck, T., Nagdyman, N., Schulze-Neick, I. et al. 87 Sildenafil Influence on Cerebral Oxygenation Measured by Near- Infrared Spectroscopy in Infants After Cardiac Surgery. Pediatr Res 56, 478 (2004). https://doi.org/10.1203/00006450-200409000-00110
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DOI: https://doi.org/10.1203/00006450-200409000-00110