What is persistent pulmonary hypertension of
the newborn (PPHN)?
Normally, the right side of the heart pumps blood to the lungs
where oxygen is moved into the blood. The left side of the heart
that receives this oxygen rich blood then pumps it to the
rest of the body. Before a baby is born, he or she
receives oxygen from the placenta. Very little blood
flows to the lungs as they are not being used.
After the baby is born and starts to breathe air,
more blood flows to the lungs to pick up oxygen
and carry it throughout the body.
Babies with PPHN have high blood pressure
(hypertension) in the vessels that carry blood from
the heart to the lungs. As a result, blood flow to the lungs
does not increase enough after birth. With less blood flow,
the body doesn’t get enough oxygen.
What are the symptoms of PPHN?
Symptoms of PPHN are due to low oxygen
levels in the body. They may include:
• Difficulty breathing
• Rapid breathing (tachypnea)
• Grunting or moaning
• Sharp pulling in of the chest muscles
during breathing (retractions)
• Bluish skin color (cyanosis) around the
mouth or on the hands or feet
What causes PPHN?
There are many possible causes of PPHN, including:
• Health conditions in the baby (for example: infections, meconium aspiration, other lung problems)
• Health conditions in the mother (for example: diabetes, use of some medicines)
How is PPHN diagnosed?
PPHN is usually diagnosed using an ultrasound of the heart (echocardiogram). In some cases,
PPHN is diagnosed based on baby’s symptoms.
What treatment will my baby receive?
In most cases, PPHN is treated by giving the baby extra oxygen.
This increases the amount of oxygen in the blood and helps
increase blood flow to the lungs.
Other treatments depend on the cause of PPHN (if known) and
the severity of the problem. Possible treatments include:
• Medicines (for example, inhaled nitric oxide helps increase
flow of blood into the lungs, surfactant helps make breathing
easier, antibiotics help treat infections, and other medicines
that help maintain blood pressure)
• Breathing support (for example, extra oxygen, continuous
positive airway pressure [CPAP], or mechanical ventilation)
• ECMO (extracorporeal membrane oxygenation) – a machine
that temporarily does the work of the baby’s lungs and/
or heart. ECMO requires surgery and can only be done at
CPAP (continuous positive airway
pressure) – a treatment that uses
mild pressurized air to keep the
Cyanosis – bluish color of the skin
Echocardiogram – ultrasound of
Hypertension – high blood
Inhaled nitric oxide – a gas that is
a drug which relaxes blood vessels
to increase blood flow to the lungs
Mechanical ventilation – using a
machine to help your baby breathe
Meconium aspiration – infant
breathes in a mixture of stool
(meconium) and amniotic fluid
around the time of delivery
Oxygen saturation – amount of
oxygen in the blood
Pulmonary – related to the lungs
Retractions – sharp pulling in of the
chest muscles during breathing
Surfactant – a liquid that keeps
the alveoli (tiny sacs in the lungs)
from collapsing while breathing out
Tachypnea – fast breathing
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