A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital

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dc.contributor.advisorMorrow, Brenda
dc.contributor.authorEl-Boraei, Samah
dc.date.accessioned2025-02-10T13:00:22Z
dc.date.available2025-02-10T13:00:22Z
dc.date.issued2024
dc.date.updated2025-02-10T12:58:21Z
dc.description.abstractBackground. The clinical profiles of African children with pulmonary hypertension (PH) are largely unknown. Sildenafil is the only available oral treatment for PH in South Africa (SA) and is widely used, mostly off-label, despite little evidence for safety or efficacy. Objectives. To describe the use of sildenafil in the Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children's Hospital (RCWMCH), to provide insights into the clinical profiles and outcomes of children with PH Methods. A retrospective descriptive study of all children treated with sildenafil in the PICU between 1 January 2017 and 31 December 2019. Results. 108 patients in 162 PICU admissions were included (median age 5 months; 54.6% male), accounting for 4.1% of all PICU admissions during the study period. Most patients (n=92, 85.2%) had congenital heart disease (CHD), which was associated with survival on univariate analysis (p=0.009). The majority (n=37, 34.3%) were classified as World Health Organisation PH Classification Group 1: Pulmonary Arterial Hypertension. Sildenafil was initiated in PICU in 98 (72.1%) cases and for inhaled nitic oxide (iNO) weaning in 56 (57.1%). For most patients, sildenafil was continued after PICU (n=104, 76.5%) and hospital (n=66, 48.5%) discharge. The three-year survival rate was 75.9 % (n=82). Conclusions. In our PICU population, sildenafil is used predominantly for CHD related PH. Sildenafil is used to facilitate iNO weaning and is frequently continued long-term after hospital discharge. Survival rates were acceptable. Research is needed to determine the true prevalence of PH and the safety profile of sildenafil in SA.
dc.identifier.apacitationEl-Boraei, S. (2024). <i>A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital</i>. (). University of Cape ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/40904en_ZA
dc.identifier.chicagocitationEl-Boraei, Samah. <i>"A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital."</i> ., University of Cape ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2024. http://hdl.handle.net/11427/40904en_ZA
dc.identifier.citationEl-Boraei, S. 2024. A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital. . University of Cape ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/40904en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - El-Boraei, Samah AB - Background. The clinical profiles of African children with pulmonary hypertension (PH) are largely unknown. Sildenafil is the only available oral treatment for PH in South Africa (SA) and is widely used, mostly off-label, despite little evidence for safety or efficacy. Objectives. To describe the use of sildenafil in the Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children's Hospital (RCWMCH), to provide insights into the clinical profiles and outcomes of children with PH Methods. A retrospective descriptive study of all children treated with sildenafil in the PICU between 1 January 2017 and 31 December 2019. Results. 108 patients in 162 PICU admissions were included (median age 5 months; 54.6% male), accounting for 4.1% of all PICU admissions during the study period. Most patients (n=92, 85.2%) had congenital heart disease (CHD), which was associated with survival on univariate analysis (p=0.009). The majority (n=37, 34.3%) were classified as World Health Organisation PH Classification Group 1: Pulmonary Arterial Hypertension. Sildenafil was initiated in PICU in 98 (72.1%) cases and for inhaled nitic oxide (iNO) weaning in 56 (57.1%). For most patients, sildenafil was continued after PICU (n=104, 76.5%) and hospital (n=66, 48.5%) discharge. The three-year survival rate was 75.9 % (n=82). Conclusions. In our PICU population, sildenafil is used predominantly for CHD related PH. Sildenafil is used to facilitate iNO weaning and is frequently continued long-term after hospital discharge. Survival rates were acceptable. Research is needed to determine the true prevalence of PH and the safety profile of sildenafil in SA. DA - 2024 DB - OpenUCT DP - University of Cape Town KW - Paediatrics and Child Health LK - https://open.uct.ac.za PB - University of Cape PY - 2024 T1 - A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital TI - A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital UR - http://hdl.handle.net/11427/40904 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/40904
dc.identifier.vancouvercitationEl-Boraei S. A Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital. []. University of Cape ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2024 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/40904en_ZA
dc.language.rfc3066Eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape
dc.subjectPaediatrics and Child Health
dc.titleA Description of the Use of Sildenafil in the Paediatric Intensive Care Unit at Red Cross War Memorial Children's Hospital
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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