We're giving her what??

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So has anyone else had experience with treating PPHN with Viagra? I read an article awhile back about it, but it seemed like it was still in the experimental phase. We have a baby now on it, and I don't know much about it or her case, other than the hype about the fact that we are using Viagra. I guess being in the big teaching hospital and all the new docs we recently got, there are going to be alot of interesting changes going on...

This baby was born at 26 weeks, back in the summer, and it seems like this is the last-ditch effort to get her off INO. I have never taken care of her, so like I said, I don't know all that much about her case.

We use it on all our PPHN kids, and we actually DON'T have it IV. It's always PO. IIRC, as was posted upthread, it was originally created for HTN, and had a very profitable side effect.

And yes, it has that same side effect on babies, too. Freaked the heck out of me the first time I encountered that... :uhoh21:

Several years ago I shadowed in the PICU and we had a kid who was getting it for PPHN. The kid was a boy about 6 (who was thankfully sedated and didn't realize it) and he did get the ...umm...side effect. His dad thought it was funny, his mom turned red when she came in the room (he was covered with a blanket, but...). It was funny for a while. Then it went on long enough that there started to be long-term damage risk. Urology actually said that he might suffer testicular damage and be unable to father children. But, taking him off the Viagra sent his PPHN through the roof. So, badness either way. What a horrible choice...I left that rotation before they figured out what to do, but I heard that Urology did some kind of procedure that was a temporary fix.

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Specializes in NICU.
I heard that Urology did some kind of procedure that was a temporary fix.

I . . . do not want to know what that procedure was. I'm not even a boy and just the idea makes me cringy.

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They probably injected phenylephrine into his member. :eek: That's what they do in the ER with men who experience "priapism, an erection lasting longer than 4 hours" which is NOT fun, is extremely painful, and if it isn't fixed, may well be the last one he ever has.

Funny, I thought Viagra, etc. wasn't supposed to work in the absence of sexual arousal? Maybe their boy parts rubbing against the sheets tripped this off or something?

(reason #34,478 why I am glad I am a woman)

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Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

I've seen the "effects" of Viagara time and time again on our kiddos.

We use sildenafil occasionally, but usually after we've used NO, and Flolan.

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Specializes in PICU.

I work in the PICU and we currently have two kids on Sildenafil. We use it quite a lot on our kids and it seems to do a good job!

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Specializes in NICU.

We use sildenafil occasionally, but usually after we've used NO, and Flolan.

Wow, I sort of love how all NICUs do things differently. I've only seen Flolan once, and it was super last-resort, on my late primary that I can't stop talking about, way back when right after he came off ECMO. IV Flolan and q30min Iloprost.

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