TY - JOUR
T1 - A retrospective review of infants receiving sildenafil
AU - De, Aliva
AU - Shah, Payal
AU - Szmuszkovicz, Jacqueline
AU - Bhombal, Shazia
AU - Azen, Stanley
AU - Kato, Roberta M.
N1 - Publisher Copyright:
© Published by the Pediatric Pharmacy Advocacy Group. All rights reserved.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - OBJECTIVE The purpose of the study was to assess mortality in an infant population receiving sildenafil. METHODS A retrospective review of hospitalized infants at Children’s Hospital Los Angeles who received sildenafil between 2008 and 2012 was conducted. Patient characteristics, comorbidities, and treatment characteristics were analyzed. Primary outcome was mortality at discharge. Sildenafil dosage ranges were based on the Sildenafil in Treatment-Naïve Children, Aged 1–17 Years, With Pulmonary Arterial Hypertension trial and were categorized as small (<1.5 mg/kg/day), medium (1.5–3.75 mg/kg/day), large (3.76–7.5 mg/kg/ day), and very large (>7.5 mg/kg/day). RESULTS A total of 147 infants were studied. A total of 82% of patients had severe pulmonary hypertension. Our data revealed 29% mortality at discharge. Mortality increased with increasing sildenafil dosage: 14% (small), 19% (medium), 49% (large), and 90% (very large). On multivariate analysis of sildenafil dosage, other pulmonary hypertension therapies, presence of persistent cardiac shunts, and duration of sildenafil, odds of dying were significantly higher with combined high and very high sildenafil dosage groups compared with combined low and medium dosage groups (OR, 13.2; CI, 4.4–39.5; p < 0.0001). CONCLUSION Sildenafil was given to critically ill infants with multiple risk factors for mortality. Although higher doses cannot be causally related to mortality, there appears to be no added benefit by escalating the sildenafil dose.
AB - OBJECTIVE The purpose of the study was to assess mortality in an infant population receiving sildenafil. METHODS A retrospective review of hospitalized infants at Children’s Hospital Los Angeles who received sildenafil between 2008 and 2012 was conducted. Patient characteristics, comorbidities, and treatment characteristics were analyzed. Primary outcome was mortality at discharge. Sildenafil dosage ranges were based on the Sildenafil in Treatment-Naïve Children, Aged 1–17 Years, With Pulmonary Arterial Hypertension trial and were categorized as small (<1.5 mg/kg/day), medium (1.5–3.75 mg/kg/day), large (3.76–7.5 mg/kg/ day), and very large (>7.5 mg/kg/day). RESULTS A total of 147 infants were studied. A total of 82% of patients had severe pulmonary hypertension. Our data revealed 29% mortality at discharge. Mortality increased with increasing sildenafil dosage: 14% (small), 19% (medium), 49% (large), and 90% (very large). On multivariate analysis of sildenafil dosage, other pulmonary hypertension therapies, presence of persistent cardiac shunts, and duration of sildenafil, odds of dying were significantly higher with combined high and very high sildenafil dosage groups compared with combined low and medium dosage groups (OR, 13.2; CI, 4.4–39.5; p < 0.0001). CONCLUSION Sildenafil was given to critically ill infants with multiple risk factors for mortality. Although higher doses cannot be causally related to mortality, there appears to be no added benefit by escalating the sildenafil dose.
KW - Infants
KW - Mortality
KW - Pediatric pulmonary hypertension
KW - Sildenafil
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U2 - 10.5863/1551-6776-23.2.100
DO - 10.5863/1551-6776-23.2.100
M3 - Review article
AN - SCOPUS:85046836445
SN - 1551-6776
VL - 23
SP - 100
EP - 105
JO - Journal of Pediatric Pharmacology and Therapeutics
JF - Journal of Pediatric Pharmacology and Therapeutics
IS - 2
ER -