This research appears in the first issue for November 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Lara Shekerdemian, M.D., of the Pediatric Intensive Care Unit at the Royal Children's Hospital in Melbourne, Australia, and five associates gave a single dose of sildenafil to 15 infants undergoing withdrawal from inhaled nitric oxide therapy. None experienced rebound pulmonary hypertension, a common therapeutic complication.
Fourteen children in the study cohort received a placebo. Ten of the 14 had an acute elevation of pulmonary artery pressure by 20 percent or more during the latter part of the weaning process.
Inhaled nitric oxide was first introduced in the early 1990s as a therapeutic agent to widen pulmonary blood vessels in ventilated lung regions by relaxing pulmonary vascular smooth muscle.
Although there have been no definitive studies of clinical benefit to date, the investigators believe that inhaled nitric oxide therapy warrants use as an adjunctive treatment in some of the sickest patients in the ICU. They call it "unrivaled" in its efficacy as a selective pulmonary vasodilator.
"An important complication that is associated with the use of inhaled nitric oxide is the development of rebound pulmonary hypertension on its withdrawal," said Dr. Shekerdemian.
All infants who failed to respond were given sildenafil during a subsequent weaning attempt more than 24 hours later and were weaned successfully from nitric oxide treatment.
The total duration of ventilation for patients given sildenafil was slightly over 28 hours, as compared with 98 hours for those taking a placebo.
"The total ICU stay after the study was completed was 47.8 hours for the sildenafil group and 189 hours for the placebo group," added Dr. Shekerdemian.
"This study is unique in a number of ways," she continued. "It is the first study to investigate the pharmacologic prophylaxis of rebound pulmonary hypertension during the primary attempt to wean from inhaled nitric oxide. This is also the first prospective trial of sildenafil in the prevention of rebound pulmonary hypertension. Moreover, this study is the first that defines the extent of the problem of rebound pulmonary hypertension in infants and children weaning from inhaled nitric oxide in the pediatric ICU."
Suzy Martin | EurekAlert!
Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University
3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg
The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.
Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...
A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.
The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
25.05.2018 | Event News
02.05.2018 | Event News
13.04.2018 | Event News
25.05.2018 | Event News
25.05.2018 | Machine Engineering
25.05.2018 | Life Sciences