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— Hipertensión Pulmonar Persistente del Nuevo Nacido (PPHN) —

The provided text appears to be a summary of the management and treatment options for Persistent Pulmonary Hypertension of the Newborn (PPHN). Here's a condensed version of the information: **Diagnosis** * Echocardiography: To screen and diagnose PPHN, and rule out structural heart lesions. * Echocardiography with Doppler and color-flow mapping: To assess intracardiac shunt direction and pulmonary arterial systolic/diastolic pressures. * Cranial ultrasonography: To assess for intraventricular bleeding and peripheral areas of hemorrhage or infarct. * Brain computed tomography scanning or magnetic resonance imaging: To evaluate for central nervous system injury. **Procedures** * Cardiac catheterization: Rarely used to exclude congenital heart disease due to echocardiographic findings being typically diagnostic. **Management** * Continuous monitoring of oxygenation, blood pressure, and perfusion. * Maintaining a normal body temperature. * Correction of electrolytes/glucose abnormalities and metabolic acidosis. * Nutritional support. * Minimal stimulation/handling of the newborn. * Minimal use of invasive procedures (e.g., suctioning). **Medical Therapy** * Inotropic support (e.g., dopamine, dobutamine, milrinone). * Surfactant administration for premature and full-term newborns with parenchymal lung disease. * Endotracheal intubation and mechanical ventilation to maintain normal functional residual capacity. * High-frequency ventilation for newborns with underlying parenchymal lung disease and low lung volumes. * Correction of hypoglycemia, hypocalcemia, acidosis, and alkalosis. * Induced paralysis (controversial) and Extracorporeal Membrane Oxygenation (ECMO) for optimal ventilatory support failure. **Pharmacotherapy** * Inhaled pulmonary vasodilators (e.g., nitric oxide) and supplemental oxygen. * Systemic vasodilators (e.g., prostacyclin, phosphodiesterase inhibitors, endothelin receptor antagonists) for chronic PPHN after the newborn period. * Prostaglandin E1 if the ductus arteriosus is closed or restrictive.
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