Use of Prostaglandin E1 in Neonates with Severe Persistent Pulmonary Hypertension (PPHN): A Narrative Review

Persistent Pulmonary Hypertension of the Newborn (PPHN) is a significant health issue characterised by the inadequate circulatory transitions at birth, subsequent to considerable hypoxaemia and increased Pulmonary Vascular Resistance (PVR). Inhaled Nitric Oxide (iNO) is the preliminary treatment approach; however, it fails to achieve favourable outcomes in approximately 30-40% of neonates. Consequently, therapeutic alternatives, particularly Prostaglandin E1 (PGE1), are capturing attention for their considerable vasodilatory features and capability to maintain Ductus Arteriosus (DA) patency. Additionally, PGE1 decreases right ventricular afterload and augments systemic oxygen delivery, thus functioning as a valuable option for managing PPHN in this vulnerable population. This review article aims to comprehensively determine the intricate role of PGE1 in the context of PPHN, focusing on its pathophysiology, clinical utility and novel treatment methods. The study also examines current research concentrating on optimising PGE1 protocols, including dosage clinical guidelines and evaluating potential long-term complications, with the objective of enhancing paediatric care through both established practices and innovative strategies.