Advances in the Management of Persistent Pulmonary Hypertension of the Newborn

This article details an integrated approach to optimize management strategies for hypoxemic respiratory failure and hemodynamic instability in persistent pulmonary hypertension of the newborn (PPHN). Even with adequate lung recruitment, inhaled nitric oxide, the only food and drug administration (FDA)-approved therapy for PPHN, fails in one-third of cases. Animal models of PPHN have enhanced understanding of PPHN pathophysiology, resulting in new targets for the development of alternative vasodilators, including phosphodiesterase inhibitors, prostaglandins, and endothelin antagonists. However, support of these therapies is limited to observational studies. Our article summarizes the available evidence for using such alternative vasodilators in PPHN infants.