Pulmonary Hypertension in Neonates: Early identification and treatment

Pulmonary hypertension (PH) in children often underrecognized due to lack of awareness to its risk factors and diagnosis tool. In neonate population, these factors become more challenging. When diagnosis is made early, the treatment can be commenced earlier for better prognosis. The objective of this article is to report explorational study of pulmonary hypertension in neonates. Medical records of neonatal intensive care unit (NICU) patients for a year was reviewed. All NICU patients underwent echocardiography screening of PH within 48 hour from admission. Patients with PH were included in the study and the data was described for sex, bodyweight, gestational status, associated conditions and outcome. In a year, 167 patients was recorded admitting NICU with male predominance (96 male versus 71 female). Twenty patients with PH were identified with male and female ratio 1:1, and low birthweight and preterm infants predominance, (12 out of 20). Furthermore asphyxia, respiratory distress syndrome, transient tachypneu of the newborn, necrotizing enterocolitis, and systemic inflammatory response syndrome were associated with PH. Five patients died during nursery. Three representative PH patients revealed dilation of right atrium and tricuspid regurgitation on echocardiography examination. These patients were put on continuous positive airway pressure machine and received oral sildenafil 2mg/kg bodyweight. One of them died due to multiple organ dysfunction syndrome. Early echocardiography revealed pulmonary hypertension in neonates.