Persisteerend Pulmonair Hypertensie van het Nieuwborning
There is no specific answer to provide as the text appears to be a medical guideline for Neonatal Pulmonary Hemorrhage (PPHN) diagnosis, management, and treatment. The text outlines various diagnostic tests, procedures, management principles, medical therapy, and pharmacotherapy options for PPHN.
However, I can summarize the main points:
**Diagnosis**
* Echocardiography to screen and assist in making the diagnosis of PPHN
* Echocardiography with Doppler and color-flow mapping to assess presence/direction of intracardiac shunt
* 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
**Management**
* General management principles include continuous monitoring, maintaining normal body temperature, correction of electrolytes/glucose abnormalities, nutritional support, minimal stimulation/handling of the newborn, and minimal use of invasive procedures.
* Medical therapy may include inotropic support, surfactant administration, endotracheal intubation and mechanical ventilation, high-frequency ventilation, correction of hypoglycemia, hypocalcemia, acidosis, and alkalosis, induced paralysis (controversial), and extracorporeal membrane oxygenation (ECMO) when optimal ventilatory support fails to maintain acceptable oxygenation and perfusion.
**Pharmacotherapy**
* Inhaled pulmonary vasodilators and supplemental oxygen
* Systemic vasodilators for chronic PPHN after the newborn period
* Prostaglandin E1 if the ductus arteriosus is closed or restrictive in the setting of suprasystemic pulmonary artery pressures and/or right ventricular dysfunction leading to poor systemic perfusion.
Please note that this summary is not a comprehensive guide, and individual treatment plans should be tailored to each patient's specific needs under the guidance of a qualified healthcare professional.