Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Efficacy of a combination of sildenafil and magnesium sulfate in the treatment of persistent pulmonary hypertension of the newborn, and its influence on hemodynamics

Shuping Huang, Tao Zhong

Department of Pediatrics, Ganzhou People’s Hospital, Ganzhou 341000, China;

For correspondence:- Tao Zhong Email: tawgw9@163.com Tel:+867975889461

Accepted: 24 September 2021 Published: 31 October 2021

Citation: Huang S, Zhong T. Efficacy of a combination of sildenafil and magnesium sulfate in the treatment of persistent pulmonary hypertension of the newborn, and its influence on hemodynamics. Trop J Pharm Res 2021; 20(10):2163-2169 doi: 10.4314/tjpr.v20i10.21

© 2021 The authors.
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Abstract

Purpose: To investigate the efficacy of the combined use of sildenafil and magnesium sulfate in the treatment of persistent pulmonary hypertension of the newborn (PPHN), and its influence on hemodynamics.

Methods: A total of 174 children with persistent pulmonary hypertension who were treated in Ganzhou People’s Hospital, Ganzhou, China were selected and randomly assigned to joint group (JG) and control group (CG), with 87 patients in each group. The CG group received magnesium sulfate, while the JG group received sildenafil plus magnesium sulphate. The respiratory parameters of the children were analyzed using blood gas analyzer, while their hemodynamic indices were evaluated using color Doppler echocardiography. The levels of cytokines and inflammatory factors were determined by enzyme-linked immunosorbent assay (ELISA).

Results: Time taken for symptom disappearance, oxygen therapy, and hospitalization period were shorter in JG than in CG (p < 0.05). Post-treatment, the respiratory parameters (PaO₂, PaCO₂, and SaO₂) in both groups s improved, with lower levels of PaO₂ and PaCO₂, and a higher level of SaO₂ in JG (p < 0.05). Following treatment, the levels of systemic vascular resistance (SVR), posterior pulmonary vascular resistance (PVR) and pulmonary artery pressure (PA) in JG were significantly reduced, relative to CG (p < 0.05). Similarly, the expression of endothelin -1 (ET-1), brain natriuretic peptide (BNP), and angiotensin 1 (ANG-1) improved, with lower levels of ET-1 and BNP, and a higher level of ANG-1 in JG (p < 0.05). There was post-treatment reduction as well in IL-6 and TNF-α, with lower levels in JG (p < 0.05). Patients in JG showed higher total treatment effectiveness and a lower incidence of adverse reactions than those in CG (p < 0.05).

Conclusion: The combined use of sildenafil and magnesium sulfate enhances the management of PPHN, ameliorates respiratory parameters, hemodynamics, and levels of cytokines and inflammatory factors. These findings provide evidence-based medical references for a new treatment strategy for PPHN.

Keywords: Sildenafil, Magnesium sulfate, Persistent pulmonary hypertension, Newborn, Hemodynamics