Kaplish Divyanshi, Vagha Jayant D, Rathod Sachin, Jain Aditya
Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 27;16(9):e70307. doi: 10.7759/cureus.70307. eCollection 2024 Sep.
Persistent Pulmonary Hypertension of the Newborn (PPHN) is a life-threatening condition characterized by the failure of normal circulatory transition after birth, leading to sustained pulmonary hypertension and severe hypoxemia. Despite advancements in neonatal care, PPHN remains a significant cause of morbidity and mortality among newborns, particularly in full-term and near-term infants. This review provides a comprehensive overview of current pharmaceutical strategies for managing PPHN, focusing on various therapeutic agents' mechanisms, efficacy, and safety. Key interventions include inhaled nitric oxide, which has become the standard treatment for reducing pulmonary vascular resistance, alongside prostacyclin analogs, phosphodiesterase inhibitors, and endothelin receptor antagonists. Additionally, extracorporeal membrane oxygenation (ECMO) is highlighted as a critical intervention for severe, refractory cases. The review also discusses emerging therapies and the potential role of personalized medicine in improving treatment outcomes. Despite the progress made, challenges remain, including the timely diagnosis of PPHN and the need for accessible treatments in resource-limited settings. As research continues to uncover the underlying pathophysiology of PPHN, it is crucial to develop more targeted and effective pharmaceutical strategies. This review aims to inform clinicians and researchers of the current state of PPHN management and the ongoing advancements that may shape future therapeutic approaches.
新生儿持续性肺动脉高压（PPHN）是一种危及生命的疾病，其特征为出生后正常循环转换失败，导致持续性肺动脉高压和严重低氧血症。尽管新生儿护理取得了进展，但PPHN仍然是新生儿发病和死亡的重要原因，尤其是在足月儿和近足月儿中。本综述全面概述了目前用于管理PPHN的药物策略，重点关注各种治疗药物的作用机制、疗效和安全性。关键干预措施包括吸入一氧化氮，它已成为降低肺血管阻力的标准治疗方法，同时还有前列环素类似物、磷酸二酯酶抑制剂和内皮素受体拮抗剂。此外，体外膜肺氧合（ECMO）被强调为严重难治性病例的关键干预措施。本综述还讨论了新兴疗法以及个性化医疗在改善治疗结果方面的潜在作用。尽管取得了进展，但挑战仍然存在，包括PPHN的及时诊断以及在资源有限环境中获得可及治疗的需求。随着研究不断揭示PPHN的潜在病理生理学，制定更具针对性和有效性的药物策略至关重要。本综述旨在让临床医生和研究人员了解PPHN管理的现状以及可能塑造未来治疗方法的持续进展。
