Lakshminrusimha S, et al. - This study entailed the analysis of the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) related to moderate or severe hypoxic ischemic encephalopathy (HIE). Findings revealed the common occurrence of PPHN among infants with moderate/severe HIE. Additionally, it correlated with severe encephalopathy, lung disease, sepsis, systemic hypotension, and increased mortality. No variation was noted in the prevalence of PPHN between infants receiving therapeutic hypothermia at 33.5°C in these 2 trials (44/197 = 22%) compared with infants receiving normothermia in the induced hypothermia trial (23/106 = 22%).

Methods

• A comparative scrutiny was performed of infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: The induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the “usual-care” arm (33.5°C for 72 hours) of the optimizing cooling trial.

Results

• Out of 303 infants with HIE from these 2 studies, 67 (22%) presented with PPHN and 236 (78%) did not.
• Infants with PPHN were compared with those without PPHN.
• Findings disclosed similar proportion of patients treated with therapeutic hypothermia in PPHN and no-PPHN groups (66% vs 65%).
• In the PPHN group, medication use during resuscitation (58% vs 44%), acidosis after birth (pH: 7.0 ± 0.2 vs 7.1 ± 0.2), severe HIE (43% vs 28%), meconium aspiration syndrome (39% vs 7%), pulmonary hemorrhage (12% vs 3%), culture-positive sepsis (12% vs 3%), systemic hypotension (65% vs 28%), inhaled nitric oxide therapy (64% vs 3%), and extracorporeal membrane oxygenation (12% vs 0%) were discovered to be more common.
• It was determined that the length of stay (26 ± 21 vs 16 ± 14 days) and mortality (27% vs 16%) were higher in the PPHN group.