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Am J Perinatol 2023; 40(14): 1495-1508
DOI: 10.1055/a-1711-0778
Review Article

Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn

Molly K. Ball 
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Ruth B. Seabrook
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Elizabeth M. Bonachea
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Bernadette Chen
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
3   Department of Pediatrics Pulmonary Hypertension Group, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
,
Omid Fathi
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Craig A. Nankervis
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Ahmed Osman
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Amy B. Schlegel
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
,
Jacqueline Magers
4   Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio
,
Taylor Kulpa
5   Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
,
Paula Sharpin
5   Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
,
Mary Lindsay Snyder
5   Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
,
Robert J. Gajarski
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
6   Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio
,
Deipanjan Nandi
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
6   Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio
,
Carl H. Backes Jr.
1   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
2   Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
6   Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio
7   Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Department of Pediatrics, Columbus, Ohio
› Author Affiliations Funding The study was funded by the Ohio Perinatal Research Network (C.H.B.) with funding number 5 R01 HL136963 (B.C.).
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Abstract

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

Key Points

  • PPHN is associated with several unique diagnoses; the associated pathophysiology is different for each unique diagnosis.

  • PPHN is a challenging, dynamic, and labile process for which optimal care requires frequent reassessment.

  • Key management goals are adequate tissue oxygen delivery, avoiding harm.

Keywords

PPHN - pulmonary vasodilators - neonatal intensive care unit - clinical management


Publication History

Received: 05 June 2021

Accepted: 30 November 2021

Accepted Manuscript online:
01 December 2021

Article published online:
11 January 2022

© 2022. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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