RecruitingPhase 1Phase 2NCT04898114

Nebulized Magnesium Sulfate and Sildenafil for Persistent Pulmonary Hypertension of Newborn

Effectiveness of Nebulized Magnesium Sulfate Combined With Sildenafil Citrate in Persistent Pulmonary Hypertension of Newborn


Sponsor

Sohag University

Enrollment

40 participants

Start Date

Jun 2, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

The aim of this study is to evaluate the effectiveness of nebulized magnesium sulfate combined with sildenafil citrate, compared with sildenafil citrate alone, in treating neonates with severe persistent pulmonary hypertension on mechanical ventilation.


Eligibility

Min Age: 6 HoursMax Age: 72 Hours

Inclusion Criteria6

  • Gestational age ≥ 36 weeks
  • Birth weight between 2.5 and 4 kg.
  • Post-natal age between 6 and 72 hours.
  • PPHN confirmed by echocardiography
  • Oxygenation index (OI) \> 30 on two occasions at least 15 minutes apart
  • Connected to Mechanical Ventilation

Exclusion Criteria9

  • Failure to obtain informed consent
  • Newborns to mothers who received magnesium sulfate within 48 hours before labor.
  • Congenital heart diseases, other than patent ductus arteriosus and foramen ovale.
  • Major congenital anomalies (including congenital diaphragmatic hernia and lung hypoplasia).
  • Prior need for cardiopulmonary resuscitation.
  • Mean arterial blood pressure (MABP) \< 35 mmHg despite therapy with volume infusions and vasoactive inotropes.
  • Impaired kidney function.
  • Prior administration of pulmonary vasodilators.
  • Gastrointestinal intolerance or bleeding

Interventions

DRUGMagnesium sulfate

Nebulized magnesium sulfate (4 ml of 6.4% solution) every 15 minutes

DRUGSildenafil Citrate

Oral sildenafil citrate at an initial dose of 1 mg/kg, with incremental increases by 0.5 mg/kg every 6 hours till reaching a target dose of 2mg/kg every 6 hours.

OTHERIsotonic saline

Nebulized isotonic saline (4 ml) every 15 minutes


Locations(1)

Neonatal Intensive Care Unit, Sohag University Hospital

Sohag, Egypt

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NCT04898114


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