Abstract:
Objective To evaluate the clinical effects of mechanical ventilation combined with sildenafil in the treatment of persistent pulmonary hypertension (PPHN) in newborns and its influence on related indicators.
Methods Sixty-eight neonates with PPHN who were admitted to our hospital from August 2016 to August 2018 were divided into either a control group (n=34) or an observation group (n=34). The control group was given mechanical ventilation+ magnesium sulfate treatment, and the observation group was given mechanical ventilation + sildenafil treatment. The changes of plasma cytokines and hemodynamics were observed.
Results After treatment, the average oxygen inhalation time and hospitalization time in the observation group were significantly shorter than those in the control group (t=7.946 and 10.307, respectively, P<0.05). Compared with the control group, the levels of systolic pulmonary artery pressure, pulmonary atresia, pulmonary vascular resistance, and systemic vascular resistance after treatment in the observation group were significantly lower than those in the control group (t=11.579, 24.081, 6.735, and 2.946, respectively, P<0.05). Regarding blood pressure indicators, systolic pulmonary artery pressure was significantly lower and systolic blood pressure was significantly higher in the observation group (t=11.579 and 5.931, respectively P<0.05). With regard to plasma cytokines, brain natriuretic peptide, endothelin, tumor necrosis factor-α, and interleukin-8 were significantly lower and angiotensin-1 was significantly higher in the observation group than in the control group (t=34.744, 6.886, 15.873, 11.036, and 5.710, respectively, P<0.05). The total effective rate was significantly higher and the incidence of overall complications was significantly lower in the observation group than in the control group [97.06%(33/34) vs 82.35%(28/34), 8.82%(3/34) vs 29.41%(10/34); χ2=5.100 and 4.660, respectively; P<0.05].
Conclusion Normal frequency mechanical ventilation combined with sildenafil can better regulate the hemodynamics and plasma cytokines and significantly improve the overall therapeutic effect in neonates with PPHN.
Key words:
Hypertension, pulmonary,
Ventilators, mechanical,
Hemodynamics,
Cytokines
Yanbo Wang, Min Li, Bao Jin, Yun Wang, Yang Chen, Jiebin Wu, Xiao Liu, Bin Zhou. Effects of mechanical ventilation combined with sildenafil on hemodynamics and cytokines in neonates with persistent pulmonary hypertension[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(09): 659-663.