Persistent Pulmonary Hypertension of the Newborn

Failure of pulmonary vascular resistance to drop after birth, causing right-to-left shunting and hypoxemia out of proportion to lung disease.

Educational decision support · Not a medical device · Do not enter PHI

Key points

Pre/post-ductal SpO2 difference >5–10%.
Echo confirms elevated PVR and right-to-left or bidirectional shunting.
Management: optimize ventilation/oxygenation, sedation, iNO, consider ECMO if OI >40 despite max support.

Pitfalls

Hyperventilation strategies cause cerebral injury — avoid.
Always rule out structural CHD before starting iNO.

Ask the Copilot

— How do I differentiate PPHN from cyanotic CHD?
— When to start iNO?