Persistent pulmonary hypertension of the term neonate: a strategy for management

Abstract

The management of 32 consecutive term infants referred with persistent pulmonary hypertension of the newborn were reviewed. Despite indices suggesting severe cardiorespiratory failure with a median alveolar-arterial oxygen gradient of 591 torr (inter-quartile range 432-618) and oxygenation index of 31 (18-44), all but one patient responded to conventional treatment with inhaled nitric oxide and high frequency oscillatory ventilation.

Conclusion: Patients should be referred early to centres where maximal conventional support can be offered before consideration for extracorporeal membrane oxygenation.