Hi everybody,how do you manage PPHN

Hello takshafat,

usually the PPHN are the big infants full term meconium asp. we immediatly put them on HFJO...on Fent. and Versed drips, and the paralizing drug as needed to keep from moving. on 100percent O2 ... ususaly Dop. and Dob. drips to maintain the blood Pressure. keep the Ph greater than 7.35 and O2 around 100. with minumal touch, sound light. and then slowly wean the Ventilator settings very slowly until down to normal. then wean the narcotics slowly...if this is unmanagable PPHN we sometimes put the infants on ECHMO. then we keep the infants awake on ECHMO.

this is what i remember ...Our Unit Protocol was.

Sister Gabrielia

NICU RNC

Long Beach Memorial Med Center CA, USA

Persistent pulmonary hypertension of the newborn is a disorder of vascular transition from fetal to neonatal circulation, manifesting as hypoxemic respiratory failure.

It's a common pathway of vascular injury activated by numerous perinatal stresses.

As with other multi factorial disorders, the optimal approach to the treatment of PPHN remains controversial.

Although, inhaled NO therapy is currently regarded as the gold standard therapy about 30% of neonates fail to respond adequately to iNO.

Further decreases in the morbidity and mortality associated with PPHN are possible with specific strategies to correct the imbalance between the vasoconstrictor and vasodilator mediators that play an important role in the regulation of the transition from a high to low pulmonary vascular resistance state and strategies to reduce lung injury.Sildenafil is being tried in many centres in India with fair results.