We present the case of a full term neonate with severe persistent pulmonary hypertension of the newborn (PPHN) after birth asphyxia cared for at the St. Elizabeth Hospital in Curacao, Netherlands Antilles. Although th...We present the case of a full term neonate with severe persistent pulmonary hypertension of the newborn (PPHN) after birth asphyxia cared for at the St. Elizabeth Hospital in Curacao, Netherlands Antilles. Although the child was ventilated with high pressures and was given high doses of cardiovascular pressors, the arterial oxygen levels remained low with an alveolar-arterial O2 gradient of 651mmHg. As a last resort, sildenafil (1.5 mg/kg)was given via a nasogastric tube. This resulted in an immediate and sustained elevation of arterial oxygenation and subsequent complete recovery. After administration of sildenafil there was a transient hypotension which was corrected by a single bolus of saline. Conclusion:We discuss the current treatment modalities of persistent pulmonary hypertension of the newborn and the potential use of phosphodiesterase 5 inhibitors such as sildenafil in a situation where the standard of practice with inhaled nitric oxide and extracorporeal membrane oxygenation is not available.展开更多
目的:探讨外源性磷酸肌酸(C P)对风心病(R H D)慢性充血性心力衰竭(C H F)的临床疗效。方法:选择80例心功能Ⅲ～Ⅳ级,平均左室射血分数(LV E F)30.2%R H D合并C H F,准备在体外循环C PB下行瓣膜置换手术患者,随机分为对照组40例和实验...目的:探讨外源性磷酸肌酸(C P)对风心病(R H D)慢性充血性心力衰竭(C H F)的临床疗效。方法:选择80例心功能Ⅲ～Ⅳ级,平均左室射血分数(LV E F)30.2%R H D合并C H F,准备在体外循环C PB下行瓣膜置换手术患者,随机分为对照组40例和实验组40例。对照组按常规方法治疗和进行术前准备,实验组加用C P(2g/d静滴),治疗2周。分别在治疗前后测定心功能评级、LV E F和6m in步行距离。结果:两组治疗后心功能、LV E F和6m in步行距离均有提高,实验组优于对照组(P<0.05)。结论:外源性磷酸肌酸对R H D并C H F患者有肯定疗效,对术前改善心功能有一定作用。展开更多
文摘We present the case of a full term neonate with severe persistent pulmonary hypertension of the newborn (PPHN) after birth asphyxia cared for at the St. Elizabeth Hospital in Curacao, Netherlands Antilles. Although the child was ventilated with high pressures and was given high doses of cardiovascular pressors, the arterial oxygen levels remained low with an alveolar-arterial O2 gradient of 651mmHg. As a last resort, sildenafil (1.5 mg/kg)was given via a nasogastric tube. This resulted in an immediate and sustained elevation of arterial oxygenation and subsequent complete recovery. After administration of sildenafil there was a transient hypotension which was corrected by a single bolus of saline. Conclusion:We discuss the current treatment modalities of persistent pulmonary hypertension of the newborn and the potential use of phosphodiesterase 5 inhibitors such as sildenafil in a situation where the standard of practice with inhaled nitric oxide and extracorporeal membrane oxygenation is not available.
文摘目的:探讨外源性磷酸肌酸(C P)对风心病(R H D)慢性充血性心力衰竭(C H F)的临床疗效。方法:选择80例心功能Ⅲ～Ⅳ级,平均左室射血分数(LV E F)30.2%R H D合并C H F,准备在体外循环C PB下行瓣膜置换手术患者,随机分为对照组40例和实验组40例。对照组按常规方法治疗和进行术前准备,实验组加用C P(2g/d静滴),治疗2周。分别在治疗前后测定心功能评级、LV E F和6m in步行距离。结果:两组治疗后心功能、LV E F和6m in步行距离均有提高,实验组优于对照组(P<0.05)。结论:外源性磷酸肌酸对R H D并C H F患者有肯定疗效,对术前改善心功能有一定作用。
