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Review
. 2022 Mar;49(1):103-125.
doi: 10.1016/j.clp.2021.11.010. Epub 2022 Jan 21.

Pulmonary Vasodilator Therapy in Persistent Pulmonary Hypertension of the Newborn

Megha Sharma  1 , Emily Callan  2 , G Ganesh Konduri  3
Affiliations
Review

Pulmonary Vasodilator Therapy in Persistent Pulmonary Hypertension of the Newborn

Megha Sharma et al. Clin Perinatol. 2022 Mar.

Abstract

Inhaled nitric oxide (iNO) therapy had a transformational impact on the management of infants with persistent pulmonary hypertension of the newborn (PPHN). iNO remains the only approved pulmonary vasodilator for PPHN; yet 30% to 40% of patients do not respond or have incomplete response to iNO. Lung recruitment strategies with early surfactant administration and high-frequency ventilation can optimize the response to iNO in the presence of parenchymal lung diseases. Alternate pulmonary vasodilators are used commonly as rescue, life-saving measures, though there is a lack of high-quality evidence supporting their efficacy and safety. This article reviews the available evidence and future directions for research in PPHN.

Keywords: Bronchopulmonary dysplasia; Cyclic GMP; Hypoxic respiratory failure; Inhaled nitric oxide; Prostaglandins.

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