title: Therapeutic strategies in pulmonary hypertension of the newborn: where are we now?
abstract: Despite recent advances, Persistent Pulmonary Hypertension of the Newborn (PPHN) still represents an important challenge for neonatologists. The care of newborns with PPHN requires meticulous therapeutic and ventilation strategies including, besides the stabilization of the newborn, the use of selective pulmonary vasodilators as inhaled Nitric Oxide (iNO). However, not all the neonates with PPHN are responsive to this clinical approach. Recent studies have proposed the use of alternative therapies to iNO, when it is not available, or there is no or only a transitory response. Sildenafil, a phosphodiesterase 5 inhibitor, appears as a frequent used therapy in refractory forms of PPHN. The aim of this review is to analyze the current therapeutic strategies in PPHN with special emphasis on iNO.
authors.affiliation: Neonatology Division, Hospital General Universitario "Gregorio Marañón", Dr Esuqerdo 46, 28009 Madrid, Spain. msanchezl.hgugm@salud.madrid.org
authors.forename: Manuel
authors.initials: M
authors.lastname: Sanchez Luna
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Franco
authors.forename: Belen
authors.initials: B
authors.lastname: Bernardo
mesh_terms: D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D012121:Respiration, Artificial; D012307:Risk Factors; D012720:Severity of Illness Index; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D009569:Nitric Oxide; D000068677:Sildenafil Citrate