[Persistent pulmonary hypertension of the newborn infant (PPHN)]

Persistent pulmonary hypertension of newborn (PPHN) is due to a defect in the adaptation of pulmonary resistance. The primary form occurs idiopathically, with meconium aspiration syndrome and with hypoplasia of the lung and is characterised by excessive muscular hyperplasia of pulmonary arteries. Secondary PPHN following hypoxia, septicaemia and shock is due to pulmonary vasoconstriction whereby thromboxane, leukotrienes and prostaglandins play a decisive role. Diseases of the pulmonary parenchyma and congenital cardiac malformations have to be excluded. The increased pulmonary resistance can be demonstrated by two-dimensional cardiography. The therapy consists of hyperventilation and tolazoline, which can be complicated by severe side-effects. High frequency oscillation and jet-ventilation are employed experimentally, Extracorporeal Membranoxygenation is a promising new method.