title: [The prevalence and characteristics of persistent pulmonary hypertension of the newborn. A multicenter study. The Study Group of the Società Italiana di Cardiologia Pediatrica (SICP)].
abstract: BACKGROUND
  Persistent pulmonary hypertension of the newborn (PPHN) is a rare syndrome with a severe prognosis, in which a prompt diagnosis can be life-saving. The aim of our study was to verify its prevalence in a neonatal population, define clinical and echocardiographic criteria for the diagnosis of PPHN and discuss therapeutic choices.
  
  
  METHODS
  The following clinical and echocardiographic criteria for the diagnosis of PPHN were defined: 1. cyanosis and hypoxemia non-responsive to O2 therapy; 2. right to left shunt at an atrial or ductal level. All neonates fulfilling these criteria referred to the neonatal units of seven pediatric or general hospitals over a two-year period were enrolled.
  
  
  RESULTS
  From January 1995 to December 1996, thirty neonates with PPHN (8%) were observed. Birth was pre-term in 5 out of 30. Ten (33%) had experienced chronic and/or fetal asphyxia (FA). Death occurred in 7 (22%), four of whom with FA. Echocardiography showed tricuspid insufficiency in 18 (60%); mean pulmonary systolic pressure was 67 +/- 16 mmHg (range 41-95). In 23 surviving neonates, normalization of clinical and echocardiographic parameters occurred in 8 +/- 5 days.
  
  
  METHODS
  In most neonates, vasodilators (tolazoline, prostacyclin) and/or nitric oxide were employed.
  
  
  CONCLUSIONS
  PPHN is confirmed to be a rare pathological condition; prognosis is severe, particularly in neonates with FA. Echocardiography is a reliable non-invasive method for a prompt diagnosis and follow-up. Subsequent studies are needed to assess therapeutic choices.
authors.affiliation: UO Cardiologia, Azienda Ospedaliera A. Meyer, Firenze.
authors.forename: S
authors.initials: S
authors.lastname: Favilli
authors.forename: L
authors.initials: L
authors.lastname: De Simone
authors.forename: I
authors.initials: I
authors.lastname: Pollini
authors.forename: M G
authors.initials: MG
authors.lastname: Bettuzzi
authors.forename: D
authors.initials: D
authors.lastname: Cianfrini
authors.forename: R
authors.initials: R
authors.lastname: Crepaz
authors.forename: V
authors.initials: V
authors.lastname: Santillo
authors.forename: D
authors.initials: D
authors.lastname: Trevisanuto
authors.forename: G
authors.initials: G
authors.lastname: Vignati
authors.forename: A
authors.initials: A
authors.lastname: Manetti
mesh_terms: D004452:Echocardiography / Q000706:statistics & numerical data; D015199:Extracorporeal Membrane Oxygenation; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D009569:Nitric Oxide / Q000627:therapeutic use; D010547:Persistent Fetal Circulation Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012121:Respiration, Artificial; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D011663:Pulmonary Surfactants; D014665:Vasodilator Agents; D009569:Nitric Oxide
vernacular_title: Prevalenza e caratteristiche della ipertensione polmonare persistente del neonato. Studio multicentrico. Gruppo di Studio della Società Italiana di Cardiologia Pediatrica (SICP).