Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?

Background Persistent pulmonary hypertension of the newborn remains a challenging problem in neonates. Some cases may be severe and not responsive to conventional respiratory support. Inhaled nitric oxide and extracorporeal membrane oxygenation have improved outcome, but these modalities are expen...

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Main Authors:	Hasan, Taufiq Hidayat, Abu Bakar, Asrar, Anuar, Muhamad Azamin, Syed Abd Hamid, Syed Abdul Khaliq, Shaban Mohamed, Mossad Abdelhak
Format:	Conference or Workshop Item
Language:	English English
Published:	2019
Subjects:	RJ Pediatrics
Online Access:	http://irep.iium.edu.my/76478/ http://irep.iium.edu.my/76478/1/poster%20PPHN.pdf http://irep.iium.edu.my/76478/2/Poster%20Presentation-Dr%20Taufiq.pdf

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recordtype	eprints
spelling	iium-764782019-12-19T06:41:49Z http://irep.iium.edu.my/76478/ Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting? Hasan, Taufiq Hidayat Abu Bakar, Asrar Anuar, Muhamad Azamin Syed Abd Hamid, Syed Abdul Khaliq Shaban Mohamed, Mossad Abdelhak RJ Pediatrics Background Persistent pulmonary hypertension of the newborn remains a challenging problem in neonates. Some cases may be severe and not responsive to conventional respiratory support. Inhaled nitric oxide and extracorporeal membrane oxygenation have improved outcome, but these modalities are expensive and unavailable at most hospitals in Malaysia. Report A 13-hour-old term female infant with congenital pneumonia was referred for nasal continuous positive airway pressure therapy. She weighed 3,300 grams and was born via elective cesarean section for oblique lie at 38 weeks gestation with rupture of membranes and clear amniotic fluid during delivery. Apgar score was 8 and 9 at 1 and 5 minutes, respectively. She became tachypneic at one hour after delivery and was given nasal prong oxygen, but still in respiratory distress. Chest radiograph showed a homogenous opacity on both lungs. WBC was 34.5x109/L and CRP was 5.31mg/L. She was intubated due to worsening respiratory distress. Despite high setting ventilator, hypoxemia persisted with oxygenation index of 70. Pre- and post-ductal oxygen saturation was 89% and 82%, respectively. Echocardiography showed persistent foramen ovale with right to left shunt, dilated right ventricle and atrium, tricuspid and pulmonary regurgitation. Magnesium sulfate (MgSO4) and sildenafil were started with inotropic support and then oxygenation index improved to 14. After ventilated for 8 days, patient was successfully extubated and then discharged at day 16 of life. Conclusion Use of MgSO4 and sildenafil in the absence of iNO and ECMO is still effective to treat PPHN. NICU with adequate equipments and neonatologist are still highly needed in Malaysia. 2019 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/76478/1/poster%20PPHN.pdf application/pdf en http://irep.iium.edu.my/76478/2/Poster%20Presentation-Dr%20Taufiq.pdf Hasan, Taufiq Hidayat and Abu Bakar, Asrar and Anuar, Muhamad Azamin and Syed Abd Hamid, Syed Abdul Khaliq and Shaban Mohamed, Mossad Abdelhak (2019) Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting? In: 3rd Kuala Lumpur International Neonatology Conference 2019 (KLINC) in Conjunction with World Prematurity Day 2019, 20th-23rd november 2019, Bandar Sunway, Petaling Jaya. (Unpublished)
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RJ Pediatrics
spellingShingle	RJ Pediatrics Hasan, Taufiq Hidayat Abu Bakar, Asrar Anuar, Muhamad Azamin Syed Abd Hamid, Syed Abdul Khaliq Shaban Mohamed, Mossad Abdelhak Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
description	Background Persistent pulmonary hypertension of the newborn remains a challenging problem in neonates. Some cases may be severe and not responsive to conventional respiratory support. Inhaled nitric oxide and extracorporeal membrane oxygenation have improved outcome, but these modalities are expensive and unavailable at most hospitals in Malaysia. Report A 13-hour-old term female infant with congenital pneumonia was referred for nasal continuous positive airway pressure therapy. She weighed 3,300 grams and was born via elective cesarean section for oblique lie at 38 weeks gestation with rupture of membranes and clear amniotic fluid during delivery. Apgar score was 8 and 9 at 1 and 5 minutes, respectively. She became tachypneic at one hour after delivery and was given nasal prong oxygen, but still in respiratory distress. Chest radiograph showed a homogenous opacity on both lungs. WBC was 34.5x109/L and CRP was 5.31mg/L. She was intubated due to worsening respiratory distress. Despite high setting ventilator, hypoxemia persisted with oxygenation index of 70. Pre- and post-ductal oxygen saturation was 89% and 82%, respectively. Echocardiography showed persistent foramen ovale with right to left shunt, dilated right ventricle and atrium, tricuspid and pulmonary regurgitation. Magnesium sulfate (MgSO4) and sildenafil were started with inotropic support and then oxygenation index improved to 14. After ventilated for 8 days, patient was successfully extubated and then discharged at day 16 of life. Conclusion Use of MgSO4 and sildenafil in the absence of iNO and ECMO is still effective to treat PPHN. NICU with adequate equipments and neonatologist are still highly needed in Malaysia.
format	Conference or Workshop Item
author	Hasan, Taufiq Hidayat Abu Bakar, Asrar Anuar, Muhamad Azamin Syed Abd Hamid, Syed Abdul Khaliq Shaban Mohamed, Mossad Abdelhak
author_facet	Hasan, Taufiq Hidayat Abu Bakar, Asrar Anuar, Muhamad Azamin Syed Abd Hamid, Syed Abdul Khaliq Shaban Mohamed, Mossad Abdelhak
author_sort	Hasan, Taufiq Hidayat
title	Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
title_short	Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
title_full	Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
title_fullStr	Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
title_full_unstemmed	Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?
title_sort	persistent pulmonary hypertension of the newborn (pphn): what can we do in low resource setting?
publishDate	2019
url	http://irep.iium.edu.my/76478/ http://irep.iium.edu.my/76478/1/poster%20PPHN.pdf http://irep.iium.edu.my/76478/2/Poster%20Presentation-Dr%20Taufiq.pdf
first_indexed	2023-09-18T21:48:02Z
last_indexed	2023-09-18T21:48:02Z
_version_	1777413581839532032

Persistent pulmonary hypertension of the newborn (PPHN): What can we do in low resource setting?

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