Analysis of the application effect of mechanical ventilation with sildenafil citrate and milrinone in the treatment of persistent pulmonary hypertension in newborns
Objective To analyze the clinical effect of mechanical ventilation with sildenafil citrate and milrinone in the treatment of persistent pulmonary hypertension in newborns.Methods A study was conducted on 48 newborns with persistent pulmonary hypertension.After enrollment,the children were divided into sildenafil group and milrinone group based on differences in treatment modes,each with 24 cases.Sildenafil group received mechanical ventilation with sildenafil citrate,and milrinone group received mechanical ventilation with milrinone.The clinical efficacy,cardiac function indicators,blood gas analysis indicators,serum factors,systolic pulmonary artery pressure(SPAP),and improvement in systemic circulation pressure between the two groups.Results The total effective rate of clinical treatment in sildenafil group(95.83%)was higher than that in milrinone group(75.00%)(P<0.05).After treatment,the right ventricular ejection fraction(RVEF)and early diastolic peak velocity(E value)were(47.82±9.18)%and(48.54±9.27)cm/s in sildenafil group,which were higher than(42.24±4.86)%and(43.46±3.73)cm/s in milrinone group;the late diastolic peak velocity(A value)in sildenafil group was(41.16±3.59)cm/s was lower than(43.81±4.07)cm/s in milinone group(P<0.05).In sildenafil group,the arterial partial pressure of carbon dioxide(PaCO2)was(34.42±3.18)mm Hg(1 mm Hg=0.133 kPa)and the inspired oxygen fraction(FiO2)was(58.54±5.27)%,which were lower than(40.24±4.86)mm Hg and(64.66±6.73)%in milrinone group;the blood oxygen saturation(SaO2)was(93.78±5.42)%and the arterial partial pressure of oxygen(PaO2)was(84.08±6.86)mm Hg,which were higher than(87.16±4.98)%and(76.96±5.63)mm Hg in milinone group(P<0.05).In sildenafil group,the C-reactive protein(CRP)was(6.46±1.18)mg/L,the matrix metalloproteinase-9(MMP-9)was(36.44±2.22)mg/L,and the B-type natriuretic peptide(BNP)was(260.31±15.45)pg/ml,which were lower than(8.83±1.58)mg/L,(42.80±3.06)mg/L,and(322.82±19.14)pg/ml in milineone group(P<0.05).The level of SPAP of(28.71±2.41)mm Hg in sildenafil group was lower than(35.94±3.56)mm Hg in milinone group(P<0.05).After treatment,sildenafil group had systolic blood pressure of(57.04±3.56)mm Hg and diastolic blood pressure of(40.54±1.07)mm Hg,which were higher than(55.17±2.61)and(39.62±1.73)mm Hg in milrinone group(P<0.05).Conclusion Introducing mechanical ventilation with sildenafil citrate into newborns with persistent pulmonary hypertension has significant therapeutic effects,which can effectively improve their cardiac function,blood gas analysis,and serum factor levels,promote the recovery of SPAP,and has clinical practical value.
万方数据
维普
