Biology Reference
In-Depth Information
There is growing evidence from vascular smooth muscle cells and various animal
models that PDEs play a critically important role in regulating pulmonary vascular
tone in the neonatal period. Two early clinical trials of sildenafil have been
completed in infants with PPHN with encouraging results, and double-blind rando-
mized controlled trials are under way to assess the effectiveness of sildenafil in
CDH and BPD. There is new clinical evidence to suggest that milrinone may be
useful in patients with neonatal pulmonary hypertension, particularly when used
in conjunction with inhaled NO. However, more data are needed from both
preclinical and clinical studies to know how to select the best combination of
PDE inhibitors for specific disease states and age groups. Until such studies have
been conducted and evaluated, the use of PDE inhibitors for neonatal pulmonary
hypertension should be confined to appropriately designed clinical trials (Shah and
Ohlsson
2007
).
Acknowledgments The authors are supported by NIH grants HL086715 (KNF) and HL54705
(RHS).
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