RT Journal Article SR Electronic T1 Sildenafil to Facilitate Weaning From Inhaled Nitric Oxide and Mechanical Ventilation in a Patient With Severe Secondary Pulmonary Hypertension and a Patent Foramen Ovale JF Respiratory Care FD American Association for Respiratory Care SP 1611 OP 1613 DO 10.4187/respcare.01147 VO 56 IS 10 A1 Shlomo Elias A1 Sigal Sviri A1 Efrat Orenbuch-Harroch A1 Yakov Fellig A1 Arie Ben-Yehuda A1 Zvi G Fridlender A1 Dan Gilon A1 Abed Bayya YR 2011 UL http://rc.rcjournal.com/content/56/10/1611.abstract AB We describe the case of a woman who presented to the intensive care unit with acute respiratory failure that required mechanical ventilation. She had severe pulmonary hypertension secondary to interstitial lung disease, and her history included sarcoidosis and tuberculosis. She was dependent on inhaled nitric oxide (INO) to maintain safe arterial oxygen saturation and could not be weaned from mechanical ventilation. Echocardiography revealed a patent foramen ovale with substantial right-to-left shunt, which probably contributed to her hypoxemia. Sildenafil enabled weaning from INO and substantially reduced the flow through the patent foramen ovale. She was successfully extubated and discharged home. To our knowledge, this is the first report of weaning from INO and mechanical ventilation in a patient with both severe secondary pulmonary hypertension and a right-to-left shunt through a patent foramen ovale.