Transport of the Neonatal Patient With Persistent Pulmonary Hypertension

Persistent pulmonary hypertension of the newborn remains a challenging condition to manage. The key to treatment is to maximize ventilatory support through conventional ventilation, high-frequency oscillator ventilation, exogenous surfactant, inhaled nitric oxide, and, if needed, extracorporeal membrane oxygenation. When these treatments are not available, the infant must be transferred to a tertiary/quaternary care center by a qualified neonatal/pediatric transport team that is equipped to transport the newborn on inhaled nitric oxide. The transport team must perform a quick and thorough assessment of the newborn, determine and initiate the appropriate treatment, evaluate the response, and transport the infant to the receiving facility as safely and quickly as possible; these steps are the key to a positive outcome. This article will review the pathophysiology, assessment, diagnosis, and treatment options for a newborn with persistent pulmonary hypertension of the newborn, and considerations for infant transport to a higher level of care will be emphasized.