MAGNESIUM SULPHATE VERSUS SILDENAFIL IN TREATMENT OF PERSISTENT PULMONARY HYPERTENSION IN NEWBORNS
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Abstract
Objective: To compare the efficacy of Magnesium Sulphate and Sildenafil in treating PPHN in newborn.
Methods: A randomized controlled study evaluated sildenafil with magnesium sulfate in 50 newborns with PPHTN. This study was done at Al-Azhar University hospitals NICU. Study subjects were split into two groups: Sildenafil-treated 25 neonates are Group 1. Group 2: 25 magnesium sulphate-treated newborns. To assess PPHN severity, an expert pediatric cardiologist monitored patients regularly. PPHN treatment entails reducing pulmonary vascular resistance below 20 mmHg and elevating systemic blood pressure to shift blood flow from the right-to-left shunt. Above 95% arterial oxygen saturation and below 30 mmHg tricuspid valve insufficiency. Results: EF was similar in both groups. Group 1's PASP by TR peak velocity dropped significantly during 3 days. Group 1's PASP by PI peak velocity dropped significantly over 3 days. Group 2's PASP by PI peak velocity dropped significantly over 6 days. Baseline PASP was similar between groups. Group 1's PASP dropped significantly after 14 days. A significant difference in SaO2 and ABG improvement time and ventilation days between groups.
Conclusion: This study shows magnesium sulfate and oral sildenafil can treat neonatal critical care unit PPHN without inhaled nitric oxide. Both medications have equal side effects and survival. Sildenafil reduced airflow. More research is needed to confirm and assess both drugs' long-term dangers. Oral sildenafil or intravenous MgSO4 are recommended when other therapies fail. Research is needed to help PPHN newborns. These medications' dose effects need more research.
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Amr Ibrahim EL Sayed Shehata
Fellow of Cardiology,Benha teaching hospital
Amr Hemeda Mostafa
Pediatric department, Faculty Of Medicine, Al-Azhar university, Cairo, Egypt.
Mahmoud Ismail Mohammed Attalah
Pediatric department Faculty Of Medicine, Al-Azhar university, Cairo, Egypt.
Seham Nabil Ramdan
Pediatric department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt.
Mona Sayed Mohammad Attaya
Pediatric department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt.
Hanan Atta
Researcher of child health at National Research Centre, Dokki ,Giza.
Abd Elsalam Abou Elnour
Radio diagnosis department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt.
Zeinab Adawy
Chest diseases department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt.
Sahar Badr El-Din
Pharmacology department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt
Hanan Ahmed Abd Almohymen ALfiky
Pharmacology department, Faculty Of Medicine For Girls, Al-Azhar university, Cairo, Egypt