Persistent pulmonary hypertension of the term neonate: a strategy for management

The management of 32 consecutive term infants referred with persistent pulm onary hypertension of the newborn were reviewed. Despite indices suggesting severe cardiorespiratory failure with a median alveolar-arterial oxygen gr adient of 591 torr (inter-quartile range 432-618) and oxygenation index of 31 (18-44), all but one patient responded to conventional treatment with in haled nitric oxide and high frequency oscillatory ventilation. Conclusion Patients should be referred early to centres where maximal conve ntional support can be offered before consideration for extracorporeal memb rane oxygenation.