Pre-operative sildenafil and pulmonary endothelial-related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery

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(6), pp. 472-480. (doi: 10.1111/j.1365-2044.2011.06702.x)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Danton, Professor Mark and Pollock, Mr James and Lyall, Professor Fiona
• Authors: Vassalos, A., Peng, E., Young, D., Walker, S., Pollock, J., MacArthur, K., Lyall, F., and Danton, M.H.D.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Anaesthesia
• ISSN: 0003-2409
• Published Online: 04 April 2011