Persistent Pulmonary Hypertension of the Newborn (PPHN) Observational Study

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