Drug | Dose | Comment |
---|---|---|
Epoprostenol intravenous | Start with 1–3 ng/kg/min, increase gradually to 60 (and more) ng/kg/min intravenous | Caution: systemic arterial hypotension. Need to change drug vial/delivery system every 12–24 h |
Iloprost inhaled, intravenous | 0.25 µg/kg inhal, max. 10 µg; 6×/day or 1–5 ng/kg/min intravenous | Caution: systemic arterial hypotension |
iNO | 2–40 ppm inhal | |
Sildenafil intravenous, oral | 0.4 mg/kg bolus over 3hrs IV (optional), then 1.6−2.4 mg/kg/day continous infusion 8–20 kg: 3×10 mg oral >20 kg: 3×20 mg oral | do not exceed 30mg/d. Higher sildenafil doses up to 7.2mg/kg/day IV have been used in newborn infants with PPHN associated with congenital diaphragmatic hernia In children weighing less than 8 kg, dosage of 1 mg/kg three time a day (oral not approved) |
Epinephrine | 0.01–1 µg/kg/min intravenous | Positive inotropy. Increases myocardial oxygen consumption, tachycardia. Moderate effects on PVR and SVR |
Norepinephrine | 0.01–1 µg/kg/min intravenous | Increases SVR and PVR |
Vasopressin | 0.0003–0.002 IU/kg/min intravenous | Probably does not increase PVR (advantage vs norepinephrine) |
Terlipressin | 5–10 ng/kg/min intravenous | Probably does not increase PVR (advantage vs norepinephrine) |
Dobutamine | 5–20 µg/kg/min intravenous | Increases myocardial oxygen consumption, tachycardia. Probably does not increase PVR |
Milrinone | 0.375–1.0 µg/kg/min intravenous | Lowers PVR. Caution: systemic arterial hypotension |
Levosimendan | 0.1 µg/kg/min intravenous | Lowers PVR. Caution: systemic arterial hypotension |
iNO, inhaled nitric oxide; PPHN, persistent pulmonary hypertension in the newborn; PVR, pulmonary vascular resistance; SVR, systemic vascular resistance.