The text appears to be a medical article related to neonatal respiratory distress syndrome (NRDS), specifically Pulmonary Persistent Hypoxemic Neonate (PPHN). Here is the extracted information in a clear and concise format: **Diagnosis** * Echocardiography: To screen for PPHN and rule out structural heart lesions * Echocardiography with Doppler and color-flow mapping: To assess intracardiac shunts and pulmonary artery pressures **Procedures** * Cranial ultrasonography: To assess intraventricular bleeding and peripheral areas of hemorrhage or infarct * Cranial ultrasonography with Doppler flow: To assess nonhemorrhagic infarcts * Brain computed tomography scanning or magnetic resonance imaging: To evaluate central nervous system injury **Management** * General principles: + Continuous monitoring of oxygenation, blood pressure, and perfusion + Maintaining 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) * Treatment strategy: + Maintain adequate systemic blood pressure + Decrease pulmonary vascular resistance + Ensure oxygen release to tissues + Minimize lesions induced by high levels of inspired oxygen and ventilator high pressure settings **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 by recruiting areas of atelectasis; to avoid overexpansion * High-frequency ventilation: Used in newborns with underlying parenchymal lung disease and low lung volumes * Correction of hypoglycemia, hypocalcemia, acidosis, and alkalosis * Induced paralysis: Controversial; typically reserved for newborns who cannot be treated with sedatives alone * Extracorporeal membrane oxygenation (ECMO): Used when optimal ventilatory support fails to maintain acceptable oxygenation and perfusion **Pharmacotherapy** * Inhaled pulmonary vasodilators (e.g., nitric oxide) and supplemental oxygen * Systemic vasodilators: Potentially beneficial for chronic PPHN after the newborn period (e.g., prostacyclin, phosphodiesterase inhibitors, endothelin receptor antagonists) * 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