PT  - JOURNAL ARTICLE
AU  - Rami Dhillon
TI  - The management of neonatal pulmonary hypertension
AID  - 10.1136/adc.2009.180091
DP  - 2012 May 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F223--F228
VI  - 97
IP  - 3
4099  - http://fn.bmj.com/content/97/3/F223.short
4100  - http://fn.bmj.com/content/97/3/F223.full
SO  - Arch Dis Child Fetal Neonatal Ed2012 May 01; 97
AB  - Most neonates with clinically significant pulmonary hypertension (PH) will have either persistent PH of the newborn (PPHN) or bronchopulmonary dysplasia. Cyanotic congenital heart disease must be actively ruled out as part of the differential diagnosis of PPHN. The maintenance of ductal patency with prostaglandins E1 or E2 in cases of doubt is safe and potentially beneficial given their pulmonary vasorelaxant properties. Specific tools in the treatment of PPHN include modern ventilatory strategies, inhaled nitric oxide, sildenafil, prostacyclin and extracorporeal membrane oxygenation. Rarely will a cardiac lesion be primarily responsible for neonatal PH although pulmonary vein stenosis and the persistence of an arterial duct must be considered, particularly in the older preterm baby with bronchopulmonary dysplasia.