Persistent pulmonary hypertension of the newborn (PPHN) arises from failure of the normal circulatory transition that occurs postnatally and is characterised by increased pulmonary vascular resistance, leading to significant respiratory distress and hypoxaemia. Oral sildenafil administration is a potential alternative treatment for PPHN, especially when inhaled nitric oxide is unavailable.A 72-hour-old term male neonate was referred on account of respiratory distress, and cyanosis was noticed at 30 minutes of life with RR of 76 bpm and SPO2 of 57% in room air. The baby was pale, cyanosed, icteric, and febrile (39.5°C). An initial assessment of Severe NNJ 20 to EONNS with background cyanotic congenital heart disease was made. An echocardiogram with colour Doppler interrogation confirmed the diagnosis of Persistent pulmonary hypertension of the newborn. The baby was commenced on compounded oral sildenafil @ 2mg/kg/dose 6 hourly in addition to oxygen therapy. Baby improved and was subsequently discharged home on oral sildenafil, which was discontinued after a normal repeat ECHO Scan done at 2 months of life. Oral compounded sildenafil was found to be a useful alternative in managing PPHN.
Michael et al. (Sun,) studied this question.