Persistent pulmonary hypertension of the newborn treated with magnesium sulfate in premature neonates.

Abstract

To evaluate the clinical effects of magnesium sulfate (MgSO4) in the treatment of persistent pulmonary hypertension of the newborn (PPHN) in premature infants. This was a prospective, nonrandomized, clinical study. Seven premature neonates with PPHN were treated with MgSO4 as soon as documentation of an interatrial right-to-left shunt was made. A loading dose of 200 mg/kg was infused over 30 minutes, followed by a maintenance dose of 20 to 50 mg/kg/h. Alveolar-arterial oxygen tension difference (AaDO2) and oxygenation index were followed up sequentially as the primary outcome measures. Blood pressures and serum electrolytes were also monitored. Six cases responded clinically. The decrease of AaDO2 reached significance at 36 hours, but the decrease of oxygenation index was not significant over 72 hours. Four infants survived. No significant side effects were encountered. Our results suggest that MgSO4 may be considered as an alternative treatment of PPHN in premature infants.