Treatment aims to increase the amount of oxygen in the blood and reverse any causes of hypoxia as well as gain adequate perfusion. Common treatments include: * Oxygen therapy * Mechanical ventilation * Pulmonary vasodilators * Nitrous Oxide Inhalation (iNO) * Sildenafil * Milrinone * Glucocorticoids The therapies available to manage PPHN include high frequency ventilation, surfactant instillation, pulmonary vasodilators, and extracorporeal membrane oxygenation. iNO is the preferred medication for PPHN due to its ability to more selectively cause pulmonary vasodilation in comparison to intravenous vasodilators. While this medication decreases the need for extracorporeal membrane oxygenation or extracorporeal life support, it has not been shown to reduce mortality. Intravenous sildenafil has been shown to have similar efficacy and is becoming more commonly used as treatment for PPHN. Assessment of the efficacy of these treatments includes chest radiographs and arterial blood gases. Signs of inefficacious treatments include prolonged capillary filling time, low pulse volume, low blood pressure, and sustained metabolic acidosis. In addition to treating the direct effects of this condition, other management strategies are implemented concurrently to stabilize the newborn.These include, but are not limited to nutritional support, reduction of stressful environment, gentle sedation, monitoring/treating acidosis and establishing normal systemic blood pressure. Challenges in developing countries: PPHN has been seen more frequently in developing countries or resource-poor areas, though it occurs across the globe. Treating this condition often involves large interdisciplinary teams, which is not always possible in developing countries. In low-resource environments, it is recommended to focus on five main bundles of management: * Increasing oxygen supply * Decreasing oxygen demand * Facilitating gas exchange * Inducing pulmonary vasodilation * Fixing metabolic disturbances
Persistent fetal circulation
Alveolar capillary dysplasia
Neonatal sepsis
Foetal cerebral redistribution
Umbilical cord compression
Shaken baby syndrome
Fetal distress
Placental insufficiency