Krishna Revanna Gopagondanahalli, Jaime Maria Tan, Joyce Khoo May Lyn, Sreekanthan Sundararaghavan, Arvind Sehgal, Wei Di Ng, Boon Siew Ooi, Mei Chien Chua, Yee Yin Tan, Min Yu Tan, Abdul Haium Abdul Alim, Victor Samuel Rajadurai
Kandang Kerbau Women’s and Children’s Hospital. Duke – National University of Singapore School of Medicine. Yong Loo Lin School of Medicine. Monash Children’s Hospital.
Singapore and Australia
Journal of Perinatology
J Perinatol 2026;
DOI: 10.1038/s41372-026-02578-0
Abstract
Objectives: To explore the clinical and hemodynamic effects of sildenafil in extreme premature population with bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH).
Study design: Single-centre retrospective study on infants born <28 weeks with BPD-PH on sildenafil. The respiratory severity score was assessed at four time points (72 h-4wks). Echocardiographic data were compared before and after sildenafil.
Results: Sixty-four infants were included. The mean gestational age was 26.1 ± 1.6 weeks. 30(47%) infants showed improvement in RSS, 17(26%) had no change and 17(26%) showed poor RSS. 15(88) in the poor RSS group had an early onset PH. The improved RSS group reduced tricuspid regurgitation (3.3 ± 0.6 to 2.7 ± 0.5 m/s, p = 0.007). The pulmonary acceleration time (PAAT), PAAT/RVET (right ventricular ejection time), and RV fractional area change showed improvement in all groups. The poor RSS group had high pretreatment systolic blood pressure (90.7 ± 8.8 vs 82.7 ± 4.4 mmHg, p = 0.04).
Conclusion: Variable clinical response to sildenafil warrants close monitoring of respiratory status.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
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