Titre du document / Document title

Phosphodiesterase inhibitors for persistent pulmonary hypertension of the newborn: A review

Auteur(s) / Author(s)

TRAVADI J. N. ⁽¹⁾ ; PATOLE S. K. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Subiaco, Western Australia, AUSTRALIE

Résumé / Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a complex syndrome with multiple causes, with an incidence of 0.43-6.8/1,000 live births and a mortality of 10-20%. Survivors have high morbidity in the forms of neurodevelopmental and audiological impairment, cognitive delays, hearing loss, and a high rate of rehospitalization. The optimal approach to the management of PPHN remains controversial. Inhaled nitric oxide (iNO) is currently regarded as the gold standard therapy, but with as many as 30% of cases failing to respond, has not proven to be the single magic bullet. Given the complex pathophysiology of the disease, any such magic bullet is unlikely. A number of recent studies have suggested a role for specific phosphodiesterase (PDE) inhibitors in the management of PPHN. Sildenafil, a specific PDE5 inhibitor, appears the most promising of such agents. We aim to review the current status and limitations of iNO and the potential of PDE inhibitors in the management of PPHN. The reasons why caution is warranted before specific PDE5 inhibitors like sildenafil are labelled as potential magic bullets for PPHN will be discussed. The need for randomized-controlled trials to determine the safety, efficacy, and long-term outcome following treatment with sildenafil in PPHN is emphasized.

Revue / Journal Title

Pediatric pulmonology   ISSN 8755-6863   CODEN PEPUES 

Source / Source

2003, vol. 36, n^o6, pp. 529-535 [7 page(s) (article)] (104 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1985) (Revue)

Mots-clés anglais / English Keywords

Cardiovascular disease ; Respiratory disease ; Human ; Enzyme ; Hydrolases ; Esterases ; Phosphoric diester hydrolases ; Newborn ; Child ; Pathophysiology ; Exploration ; Pulmonary artery ; Hemodynamics ; Arterial pressure ; Lung function ; Enzyme inhibitor ; Phosphodiesterase I ; Pulmonary hypertension ;

Mots-clés français / French Keywords

Appareil circulatoire pathologie ; Appareil respiratoire pathologie ; Homme ; Enzyme ; Hydrolases ; Esterases ; Phosphoric diester hydrolases ; Nouveau né ; Enfant ; Physiopathologie ; Exploration ; Artère pulmonaire ; Hémodynamique ; Pression artérielle ; Fonction respiratoire ; Inhibiteur enzyme ; Phosphodiesterase I ; Hypertension artérielle pulmonaire ;

Mots-clés espagnols / Spanish Keywords

Aparato circulatorio patología ; Aparato respiratorio patología ; Hombre ; Enzima ; Hydrolases ; Esterases ; Phosphoric diester hydrolases ; Recién nacido ; Niño ; Fisiopatología ; Exploración ; Arteria pulmonar ; Hemodinámica ; Presión arterial ; Función respiratoria ; Inhibidor enzima ; Phosphodiesterase I ; Hipertensión arterial pulmonar ;

Mots-clés d'auteur / Author Keywords

phosphodiesterase inhibitors ; pulmonary hypertension ; neonates ; nitric oxide ;

Localisation / Location

INIST-CNRS, Cote INIST : 21407, 35400011889152.0120