Sildenafil for treating patients with COVID-19 and perfusion mismatch: a pilot randomized trial

Vista sencilla de ítem
dc.contributor.authorSantamarina, M.
dc.contributor.authorBeddings, I.
dc.contributor.authorLomakin, F.
dc.contributor.authorBoisier Riscal, D.
dc.contributor.authorGutiérrez Claveria, M.
dc.contributor.authorVidal Marambio, J.
dc.contributor.authorRetamal Báez, N.
dc.contributor.authorPavez Novoa, C.
dc.contributor.authorReyes Allende, C.
dc.contributor.authorFerreira Perey, P.
dc.contributor.authorGutiérrez Torres, M.
dc.contributor.authorVillalobos Mazza, C.
dc.contributor.authorVergara Sagredo, C.
dc.contributor.authorAhumada Bermejo, S.
dc.contributor.authorLabarca Mellado, E.
dc.contributor.authorBarthel Munchmeyer, E.
dc.contributor.authorMarchant Ramos, S.
dc.contributor.authorVolpacchio, M.
dc.contributor.authorVega, J.
dc.date.accessioned2022-04-21T17:48:18Z
dc.date.available2022-04-21T17:48:18Z
dc.date.issued2022-01
dc.descriptionIndexación: Scopus.es
dc.description.abstractBackground: SARS-CoV-2 seems to affect the regulation of pulmonary perfusion. Hypoperfusion in areas of well-aerated lung parenchyma results in a ventilation–perfusion mismatch that can be characterized using subtraction computed tomography angiography (sCTA). This study aims to evaluate the efficacy of oral sildenafil in treating COVID-19 inpatients showing perfusion abnormalities in sCTA. Methods: Triple-blinded, randomized, placebo-controlled trial was conducted in Chile in a tertiary-care hospital able to provide on-site sCTA scans and ventilatory support when needed between August 2020 and March 2021. In total, 82 eligible adults were admitted to the ED with RT-PCR-confirmed or highly probable SARS-COV-2 infection and sCTA performed within 24 h of admission showing perfusion abnormalities in areas of well-aerated lung parenchyma; 42 were excluded and 40 participants were enrolled and randomized (1:1 ratio) once hospitalized. The active intervention group received sildenafil (25 mg orally three times a day for seven days), and the control group received identical placebo capsules in the same way. Primary outcomes were differences in oxygenation parameters measured daily during follow-up (PaO2/FiO2 ratio and A-a gradient). Secondary outcomes included admission to the ICU, requirement of non-invasive ventilation, invasive mechanical ventilation (IMV), and mortality rates. Analysis was performed on an intention-to-treat basis. Results: Totally, 40 participants were enrolled (20 in the placebo group and 20 in the sildenafil group); 33 [82.5%] were male; and median age was 57 [IQR 41–68] years. No significant differences in mean PaO2/FiO2 ratios and A-a gradients were found between groups (repeated-measures ANOVA p = 0.67 and p = 0.69). IMV was required in 4 patients who received placebo and none in the sildenafil arm (logrank p = 0.04). Patients in the sildenafil arm showed a significantly shorter median length of hospital stay than the placebo group (9 IQR 7–12 days vs. 12 IQR 9–21 days, p = 0.04). Conclusions: No statistically significant differences were found in the oxygenation parameters. Sildenafil treatment could have a potential therapeutic role regarding the need for IMV in COVID-19 patients with specific perfusion patterns in sCTA. A large-scale study is needed to confirm these results.es
dc.description.urihttps://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03885-y
dc.identifier.citationCritical Care, Volume 26, Issue 1, December 2022, Article number 1es
dc.identifier.doi10.1186/s13054-021-03885-y
dc.identifier.issn1364-8535
dc.identifier.urihttps://repositorio.unab.cl/xmlui/handle/ria/22352
dc.language.isoenes
dc.publisherBioMed Central Ltdes
dc.rights.licenseAttribution 4.0 International (CC BY 4.0)
dc.rights.urihttps://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03885-y#rightslink
dc.subjectBlood gas analysises
dc.subjectCOVID-19es
dc.subjectIntensive care unites
dc.subjectLength of stayes
dc.subjectMechanical ventilationes
dc.subjectSildenafiles
dc.subjectSubtraction CT angiographyes
dc.subjectVentilation–perfusion ratioes
dc.subjectHypoxaemiaes
dc.subjectHappy Hypoxiaes
dc.titleSildenafil for treating patients with COVID-19 and perfusion mismatch: a pilot randomized triales
dc.typeArtículoes
Archivos
Bloque original
Mostrando 1 - 1 de 1
Miniatura
Nombre:
Santamarina_Sildenafil for treating patients with COVID-19 and perfusion mismatch a pilot randomized trial.pdf
Tamaño:
2.31 MB
Formato:
Adobe Portable Document Format
Descripción:
TEXTO COMPLETO EN INGLES
Descargar
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
1.71 KB
Formato:
Item-specific license agreed upon to submission
Descripción:
Descargar
Colecciones
FM - Artículos de Revista