Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Sex
Any
Trial phase
Phase 2
Study type
Interventional
Purpose
Treatment
Participants needed
40 (estimated)
Sponsor
University of Utah · Other
Who this trial is looking for
This trial is looking for infants with congenital diaphragmatic hernia who have had surgery to repair the condition. Participating involves getting consent from parents and undergoing an echocardiogram to assess heart function after surgery.
Are You a Good Fit for This Trial?
Must not be takingFluconazole
Rules you outSevere congenital heart defect
You may be able to join if
I am an infant admitted to the Primary Children's Hospital NICU.
I have been diagnosed with congenital diaphragmatic hernia.
I have had surgical repair of the diaphragmatic defect.
I have had an echocardiogram 48-72 hours after the repair.
My echocardiogram shows a left ventricular eccentricity index (LVEI) of 1.4 or higher.
My parents have given consent within 24 hours after the echocardiogram.
You may not be able to join if
I have congenital diaphragmatic hernia but did not have surgical repair.
I did not have an echocardiogram 48-72 hours after the repair.
My echocardiogram shows an LVEI of less than 1.4.
I have a severe congenital heart defect that needs repair.
I am allergic to sildenafil.
I am being treated with fluconazole at the time of starting the study drug.
My parents cannot provide consent within 24 hours of the echocardiogram.
I am on extracorporeal membrane oxygenation (ECMO) at the time of the study.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer three quick questions written from this study's own rules to see if you may qualify. No account needed to find out.
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 3000 US live births, similar to the incidence seen within the Utah Birth Defects cohort. The diaphragmatic defect compromises lung growth and alters pulmonary vascular development. This is reflected postnatally as respiratory failure, pulmonary hypertension (PH) and overall cardiopulmonary dysfunction, particularly post-repair. Cur…
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 3000 US live births, similar to the incidence seen within the Utah Birth Defects cohort. The diaphragmatic defect compromises lung growth and alters pulmonary vascular development. This is reflected postnatally as respiratory failure, pulmonary hypertension (PH) and overall cardiopulmonary dysfunction, particularly post-repair. Currently, optimal management of post-repair PH remains poorly investigated. Sildenafil citrate is a highly selective phosphodiesterase-5 inhibitor that increases cGMP levels, leading to smooth muscle relaxation and an anti-proliferative effect within the pulmonary vasculature. It is used off-label for many neonatal PH disorders, including PH associated with bronchopulmonary dysplasia and idiopathic persistent PH. Most neonates with CDH born within the Mountain West referral basin are managed at a quaternary care center, Primary Children's Hospital (PCH). Of these neonates with PH, approximately 25% have been treated with off-label sildenafil. However, neither the PCH clinical care group nor others have developed/published a standardized approach for either initiating or discontinuing sildenafil therapy in this group of patients. Thus, the aim of this study is to assess the safety and effectiveness of sildenafil therapy for PH in neonates with CDH within the Utah cohort. Given the relatively short-term outcome and small sample size for this trial, the plan is to use this data to support a larger multicenter randomized trial targeting long-term cardiopulmonary outcomes of infants with CDH and post-repair PH.
Trial Locations
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Status
Eligibility Criteria
Inclusion Criteria:
* Infants admitted to PCH NICU
* Diagnosis of congenital diaphragmatic hernia (CDH)
* Status post-surgical repair of diaphragmatic defect
* Has an echocardiogram 48-72 hours after repair with left ventricular eccentricity index (LVEI) ≥ 1.4
* Parental consent obtained within 24 …
Inclusion Criteria:
* Infants admitted to PCH NICU
* Diagnosis of congenital diaphragmatic hernia (CDH)
* Status post-surgical repair of diaphragmatic defect
* Has an echocardiogram 48-72 hours after repair with left ventricular eccentricity index (LVEI) ≥ 1.4
* Parental consent obtained within 24 hours after the above echocardiogram
Exclusion Criteria:
* Infants with CDH who do not undergo surgical repair
* Does not have an echocardiogram 48-72 hours post-repair
* Has LVEI \< 1.4 on above echocardiogram
* Has concurrent severe congenital heart defect that requires neonatal cardiac repair
* Has a documented sildenafil allergy
* Concurrent therapy with fluconazole at time of study drug initiation
* Inability to obtain parental consent within 24 hours of the echocardiogram
* Receiving extracorporeal membrane oxygenation (ECMO) at the time of the study
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