Persistent Pulmonary Hypertension of the Newborn (PPHN) Observational Study
Persistent Pulmonary Hypertension of the Newborn (PPHN) Observational Study
This study was an observational study to estimate the prevalence of Persistent pulmonary
 hypertension of the newborn (PPHN) among term or near-term infants with severe respiratory
 disease.
The optimal approach to the treatment of PPHN remains controversial. In 1978,
 hyperventilation was advocated for the treatment of PPHN. Newer therapies such as alkali
 infusion have been introduced without the support of randomized trial. In addition, in 1993,
 large controlled trials of inhaled nitric oxide were in the planning stages. There is a lack
 of knowledge about how these diverse management styles impact patient outcome.

 Given the large number of treatments used in neonates with PPHN, we wished to document
 treatment of PPHN and outcomes of those treatments. Therefore, we performed a prospective,
 observational study to document prevalence of PPHN, the treatments and outcomes in a large
 population of infants treated at the 12 centers of the National Institute of Child Health and
 Human Development (NICHD) Neonatal Research Network. Further, we sought to compare treatment
 with hyperventilation to treatment with alkali infusion.
Inclusion Criteria:

 -  >= 34 weeks gestational age

 -  On mechanical ventilation and/or fraction of inspired oxygen >0.50; and

 -  Had documented pulmonary artery hypertension as defined by either two-dimensional
 echocardiographic evidence of elevated pulmonary pressure (judged by right to left or
 bidirectional shunt), or a preductal to postductal oxygen gradient >20 mm Hg

 Exclusion Criteria:

 -  >7 days of age