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Pre‐operative sildenafil and pulmonary endothelial‐related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery *
Author(s) -
Vassalos A.,
Peng E.,
Young D.,
Walker S.,
Pollock J.,
MacArthur K.,
Lyall F.,
Danton M. H. D.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06702.x
Subject(s) - medicine , sildenafil , cardiopulmonary bypass , anesthesia , vascular resistance , cardiac surgery , placebo , cardiac index , ventricle , pulmonary function testing , cardiology , cardiac output , hemodynamics , alternative medicine , pathology
Summary In a randomised trial, we compared the effects of oral sildenafil (0.5 mg.kg −1 ) and placebo, administered the day before cardiac surgery, in 24 children. In sildenafil vs placebo patients, pre‐cardiopulmonary bypass median (IQR [range]) cyclic‐guanosine‐monophosphate was not significantly different (29.9 (2.1–208.1 [0.5–391.5]) vs 5.2 (0.3–54.6 [0–628.9]) pmol.ml −1 , respectively). Post‐cardiopulmonary bypass, nitrate/nitrite levels were also not significantly different (0.7 (0–8.0 [0–142.8]) vs 0 (0–2.7 [0–52.7]) μM, respectively). Postoperatively, mean (SD) pulmonary vascular resistance (2.64 (2.28) vs 1.90 (1.12) WU.m −2 , respectively and oxygenation index (5.29 (4.60) vs 3.38 (2.54), respectively) remained unchanged, whilst oxygen delivery (57.18 (21.24) vs 74.13 (35.46) ml.min −1 .m −2 , respectively) and bi‐ventricular systolic function (left ventricle 3.78 (0.94) vs 4.55 (1.08) cm.s −1 , respectively; p = 0.002; right ventricle 6.93 (1.47) vs 8.09 (2.25) cm.s −1 , respectively; p < 0.001) were significantly reduced in the sildenafil group. In this trial, pre‐operative sildenafil did not affect postoperative pulmonary vascular resistance. There was, however, a negative impact on ventricular function and oxygenation.