DOI: 10.36347/sjams.2021.v09i10.008

Pages: 1525-1532

Introduction: In persistent pulmonary hypertension of the newborn (PPHN), some neonates do not response to single pulmonary vasodilator drug, so recently combination therapy is being tried to decrease pulmonary artery systolic pressure (PASP). The aim of the study was to compare the efficacy of oral sildenafil alone with combination of oral sildenafil and milrinone in neonates suffering from PPHN. Methods: This RCT study was conducted in Dhaka Shishu (Children) Hospital, from July 2018 to June 2020. Sixty eight (68) term and near term neonates aged <10 days (34 cases in each group) with moderate to severe PPHN were taken. Monotherapy with oral sildenafil was given in group-A and combined therapy with oral sildenafil and i/v milrinone in Group-B. Serial echocardiography was done at before starting the therapy, at 3 days and at 5 days of treatment. Data regarding baseline characteristics, clinical features, PASP, PO2, Spo2, hospital stay, mortality and others investigations were recorded and analyzed with SPSS version-26. Results: Post treatment PASP was significantly reduced in group A (sildenafil) and group-B (sildenafil plus milrinone) (p<0.05). But in combination group PASP was more reduced than monotherapy group (p<0.05). Within the group, the oxygen saturation and PO2 significantly improved in both groups (p<0.05) but no significant difference was found in between two groups (p>0.05). Adrenaline infusion, hypotension and less hospital stay were significantly seen (P<0.05) in combination group. Conclusion: Combined therapy with oral sildenafil and milrinone are more effective than monotherapy with oral sildenafil in reduction of PASP. Both therapies are effective in improvement of oxygenation.