Magnesium Sulphate Versus Sildenafil in the Treatment of Persistent Pulmonary Hypertension of the Newborn

Abstract

Background: The present study aimed at evaluating the efficacy of both oral sildenafil and magnesium sulfate (MgSO4) in the treatment of persistent pulmonary hypertension of the newborn (PPHN). Methods: A randomized clinical trial including 200 neonates diagnosed clinically with PPHN and confirmed by echocardiography who were randomly divided into two groups: group S; included 100 neonates treated with sildenafil, and group M included 100 neonates treated with MgSO4. Results: Both groups showed a significant improvement in their pulmonary artery pressure 48 hours after therapy as compared to their baseline measurements. However EPAP was significantly lower five days after therapy in neonates receiving sildenafil (24.7 ± 4.3 mmHg) as compared to those receiving MgSO4 (36.2 ± 3.6 mmHg); P = 0.012. The sildenafil group also showed a significantly shorter duration to improvement of oxygenation (P = 0.02) and a shorter duration on mechanical ventilation (P = 0.03). Limited side effects and comparable survival rates were observed in both groups. Conclusion: Sildenafil is a more effective therapeutic option in the treatment of PPHN as compared to MgSO4.