Presented in part at the 37th Annual Scientific Joint Meeting of the Association of Paediatric Anaesthetists of Great Britain and Ireland and Canadian Pediatric Anesthetic Society, Glasgow, UK, May 2010 and at the 90th Annual Meeting of the American Association for Thoracic Surgery, Toronto, Canada, May 2010.
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ORIGINAL ARTICLE
Pre-operative sildenafil and pulmonary endothelial-related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery†
Article first published online: 4 APR 2011
DOI: 10.1111/j.1365-2044.2011.06702.x
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland
Additional Information
How to Cite
Vassalos, A., Peng, E., Young, D., Walker, S., Pollock, J., MacArthur, K., Lyall, F. and Danton, M. H. D. (2011), Pre-operative sildenafil and pulmonary endothelial-related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery. Anaesthesia, 66: 472–480. doi: 10.1111/j.1365-2044.2011.06702.x
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Publication History
- Issue published online: 16 MAY 2011
- Article first published online: 4 APR 2011
- Accepted: 19 February 2011
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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.