Abstract
Persistent pulmonary hypertension of the newborn (PPHN) is a complication of several
respiratory diseases characterized by an elevation in pulmonary vascular resistance
with resultant right-to-left shunting of blood and severe hypoxemia in the neonatal
period. PPHN carries a high rate of morbidity and mortality, particularly in limited-resource
settings (low-income and/or developing country). Echocardiography remains the gold
standard for diagnosis of PPHN. Modern therapies such as inhaled nitric oxide, high-frequency
oscillatory ventilation, extracorporeal membrane oxygenation, and/or other pulmonary
vasodilators agents can reduce the mortality rate of PPHN. Unfortunately, echocardiography
and the use of these modern therapies are often difficult for a medical institution
to provide for patients in developing countries, even when a timely diagnosis of PPHN
has been made. In this review, the practical challenges of timely diagnosis of PPHN
and efficient use of available treatment options faced by pediatricians or neonatologists
in limited-resource settings are discussed.
Keywords
persistent pulmonary hypertension of the newborn - developing country - diagnosis
- management - newborn
