Evidence-Based Management of Persistent Pulmonary Hypertension

Persistent pulmonary hypertension of the newborn is characterized by elevated pulmonary vascular resistance, impaired oxygenation, and delayed transition from fetal to adult circulation. Managing infants with pulmonary hypertension is particularly challenging because of the intricate and multifactorial nature of the underlying pathophysiology. A comprehensive and consistent approach to care for these critically ill infants is essential. Although numerous interventions have been extensively studied, a lack of consensus persists in clinical practice, and until recently no formal evidence-based guidelines were available. Developing a bundle of evidence-based interventions available at specific Level III NICUs may increase stabilization and decrease the need for transfer to a Level IV NICU in this high-risk population.