Abstract
Background: Persistent pulmonary hypertension of the newborn (PPHN) is a potentially life threatening disorder with a mortality of 10-20%. Current treatment strategies include mechanical Ventilation, surfactant replacement, vasodilator agents, inhaled nitric oxide and BCMO.
Aims: The aim of this study was to determine the efficacy of MgS04 in the treatment of PPHN.
Methods: This study is a retrospective review of infants with PPHN who were treated with magnesium Sulphate in a tertiary neonatal centre over five years, 1995-2000. The primary outcome measures were reduction in Oxygenation Index (01) and survival with normal neurodevelopmental examination.
Results: Thirty-one newborn infants who received MgS04 therapy for PPHN were reviewed. Twenty- five infants were> 34 weeks gestation. Fifteen infants had birth asphyxia, 8 (25%) had meconium aspiration syndrome, three had primary PPHN and two had congenital diaphragmatic hernia. The 01 decreased significantly after 12 hours of magnesium sulphate infusion from 27 to 17 mm Hg (P <0.001). The primary outcome showed that
102 Sudanese Journal of PAEDIATRICS - VOL.8-2007 27 patients (87%) survived with normal neurodevelopmental examination. Three patients were treated with nitric oxide therapy; one of them failed nitric oxide and responded to ECMO. One patient has cerebral palsy and two have hypertonia and dyskinesia.
Conclusion: MgS04 appears to be safe and effective in this cohort. It may have a place in the treatment of PPHN especially in areas where NO and ECMO is not available. Abbreviations: PPHN, persistent pulmonary hypertension of the newborn; 01, oxygenation index; ECMO, extra corporal membrane oxygenation; CDH, congenital diaphragmatic hernia; MAS, meconium aspiration syndrome; MgS04, magnesium sulphate.