Sildenafil Decreases Pulmonary Hypertension in a Mechanically Ventilated Patient with Idiopathic Pulmonary Fibrosis-A Case Report

Sildenafil (Viagra), a phosphodiesterase-5 (PDE-5) inhibitor, has been shown to reduce pulmonary arterial pressure in patients with either primary or secondary pulmonary hypertension. However, to our knowledge, the use of sildenafil in mechanically ventilated patients with pulmonary hypertension has never been reported. Herein, we described the case of a patient with idiopathic pulmonary fibrosis and secondary pulmonary hypertension, who was intubated due to acute respiratory failure. Oral sildenafil was given for persistent hypoxemia and pulmonary hypertension. The patient's pulmonary artery pressure decreased after sildenafil (from 60/27mmHg to 36/19mmHg, half an hour post-sildenafil intake), but the aim of improving oxygenation was not reached during treatment. He ultimately died of refractory hypoxemia.