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Use of Sildenafil and l-arginine in Preventing Neonatal Necrotizing Enterocolitis: An Experimental Model in Rats


 Necrotizing enterocolitis (NEC) has a 45% mortality in neonatal intensive care units. This paper aimed to evaluate the isolated and combined effects of sildenafil and l-arginine in intestinal wall and survival rates. Neonatal rats were fed formula milk and submitted to hypoxia under a 100% N2 atmosphere for 70 seconds. Then, animals were subjected to hypothermia (4ºC for 10 minutes), twice a day for three days. Forty neonatal rats were divided into five groups: negative control – not submitted to the protocol (n = 5), sildenafil group - NEC protocol (n = 9), l-arginine group - NEC protocol (n = 9), l-arginine and sildenafil group - NEC protocol (n = 9) and positive control - NEC protocol and intraperitoneal saline solution (n = 8). Jejunum and terminal ileus were removed for histopathologic and immunohistochemical Ki-67 analysis. Kruskal-Wallis test was used to analyze mortality, survival, body weight, intestinal injury score and Ki-67 proliferation index. All animals submitted to the protocol developed enterocolitis. Mortality rate was higher in group that received only l-arginine (p = 0.0293). The Ki-67 analysis showed a higher proliferative index in groups that received interventional drugs (p = 0.017). In conclusion, sildenafil and l-arginine were not effective to reduce intestinal injury.