About this trial
Around the time of birth, some babies experience a condition called asphyxia, which means that their brain and other organs do not receive enough blood and/or oxygen to work properly. This life-threatening condition accounts for nearly 1 out of 4 deaths of all babies around the world, and often leads to severe brain damage, cerebral palsy, epilepsy, and trouble with learning and functioning in everyday life. At this time, no treatment is available to repair the brain damage caused by asphyxia. Excitingly, a drug called sildenafil (Viagra®) is already given safely to babies who suffer from increased blood pressure in their lungs' vessels. Recent studies using a laboratory model of asphyxia at birth suggest that sildenafil may also repair the brain damage caused by asphyxia. Similarly, recent small studies have shown that it is both feasible and safe to give sildenafil to human babies, who suffered from asphyxia at birth. These studies also highlight the first promising signs that sildenafil may improve how the brains of these babies work, which is consistent with the abovementioned laboratory studies.
On the basis of these previous researches, the investigators predict that sildenafil can repair the damage to a baby's brain. The investigators will test whether sildenafil can be safely given to a large group of human babies who suffer from asphyxia at birth, and will confirm whether sildenafil improves or not how their brains and hearts/lungs work.
This project will enable to determine whether sildenafil is a promising treatment for repairing brain damage in babies who suffer from asphyxia at birth. This project may also provide new solutions for these babies to improve their future life.
Eligibility criteria
Qualifiers
Gestational age ≥36weeks and birth weight ≥1800g;
Evidence of fetal distress, i.e., history of an acute perinatal event, cord pH ≤7.0 or base deficit
16 mEq/L;
Evidence of neonatal distress, such as an Apgar score ≤5 at 10 minutes, postnatal blood gas pH obtained within the first hour of life ≤ 7.0 or base deficit ≤ - 16 mEq/L, or a continued need for ventilation initiated at birth and continued for at least 10 minutes;
Disqualifiers
Neonates with complex congenital heart disease
Neonates with cerebral malformations
Neonates with genetic syndrome
Neonates with intraventricular and/or intraparenchymal hemorrhage on MRI performed on day 2 of life
Trial design
Treatments tested in this trial
- Sildenafil
- Ora-Blend
Treatment groups
Sponsors and collaborators
Pia Wintermark
Lead sponsor
McGill University Health Centre/Research Institute of the McGill University Health Centre
Sponsor institution