Management of Pulmonary Arterial Hypertension in the Neonatal Unit

This review article discusses the pathophysiology and management of pulmonary hypertension (PH) in the newborn unit. The discussion revolves around 2 aspects: persistent pulmonary hypertension in the newborn, which is seen in the first few weeks of life, and PH associated with chronic lung disease in the post neonatal period of infancy. Although the etiopathogenesis as well as prognosis for infantile PH differ from older children and adults, the basic principles of management are similar. Inhaled nitric oxide, intravenous prostacyclin and its analogs, and oral medications like sildenafil and endothelin receptor blockers play a very important role in PH management in the newborn unit, in addition to ventilation strategies and acid-based balance management.