Am J Perinatol
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

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
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.).

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.

Code Availability

Not applicable.


Ethics Approval

Not applicable.


Consent to Participate

Not applicable.


Consent to Publication

Not applicable.




Publication History

Received: 05 June 2021

Accepted: 30 November 2021

Publication Date:
01 December 2021 (online)

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