PERSISTENT PULMONARY-HYPERTENSION OF THE NEWBORN - ROLE OF NITRIC-OXIDE AND ENDOTHELIN IN PATHOPHYSIOLOGY AND TREATMENT

Persistent pulmonary hypertension of the newborn (PPHN) results in sig nificant morbidity and mortality in otherwise normal term infants. Saf e, effective therapies for PPHN will only be possible when they can be directed toward the specific defects producing this condition. In thi s review, the authors discuss three different categories of mediators that may play a role in the normal transition at birth and in the path ophysiology seen in PPHN: (I) Lipid mediators, (2) the peptide endothe lin, and (3) the oxidant radical, nitric oxide. The potential of using the last mediator, nitric oxide, as a treatment for PPHN is under int ensive investigation and is discussed in the final section.