What is the role of surfactant therapy in the treatment of persistent pulmonary hypertension of the newborn (PPHN)?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Answer

Answer

Surfactant therapy does not appear to be effective when PPHN is the primary diagnosis [33] ; however, it should be considered in patients with parenchymal lung disease, such as respiratory distress syndrome, meconium aspiration syndrome, pneumonia, or sepsis, which is often associated with surfactant deficiency, inactivation, or both.

Single-center trials have shown that surfactant improves oxygenation, reduces air leak, and reduces the need for extracorporeal membrane oxygenation (ECMO) in infants with meconium aspiration. [34] A multicenter trial showed benefit in infants with parenchymal lung disease, such as meconium aspiration syndrome and sepsis, but this trial failed to show reduction in ECMO use in newborns with idiopathic PPHN. [33]


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