Abstract
The Sri Lanka Journal of Perinatal Medicine (SLJPM) was launched in 2019 as the official journal of the Perinatal Society of Sri Lanka. This journal is unique in the fact that it brings together three core specialties of perinatal medicine - obstetrics, neonatology and community medicine. It is an open access peer reviewed journal containing original research articles, expert reviews, current practices and other articles of interest to all involved in perinatal medicine.
Highlights
This guideline is prepared based on the available evidence to provide optimum care for newborns with persistent pulmonary hypertension (PPHN) and ensure that inhaled nitric oxide is used in a safe, effective, appropriate and cost-effective way for newborns with PPHN in the neonatal intensive care unit.Persistent Pulmonary Hypertension is a failure of pulmonary vascular resistance to fall post natally at any gestation
- Conditions with abnormal pulmonary vasculature include chronic foetal hypoxia, oligohydramnios and congenital diaphragmatic hernia, which tend to be less responsive to pulmonary vasodilators and may benefit from lung protective ventilation strategies
Oxygenation is defined by mean airway pressure (MAP) and FiO2
Summary
This guideline is prepared based on the available evidence to provide optimum care for newborns with persistent pulmonary hypertension (PPHN) and ensure that inhaled nitric oxide (iNO) is used in a safe, effective, appropriate and cost-effective way for newborns with PPHN in the neonatal intensive care unit. Its aetiology may be classified by normal or abnormal pulmonary vasculature development. - Conditions with normal pulmonary vasculature include meconium aspiration, asphyxia states and congenital pneumonia, which tend to respond more quickly to treatment and may tolerate more aggressive measures. Abnormal transition without parenchymal lung disease rarely requires inhaled nitric oxide. - Conditions with abnormal pulmonary vasculature include chronic foetal hypoxia, oligohydramnios and congenital diaphragmatic hernia, which tend to be less responsive to pulmonary vasodilators and may benefit from lung protective ventilation strategies. Most cases of idiopathic PPHN probably belong to this group
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