Role of magnesium sulphate in treatment of severe persistent pulmonary hypertension of the neoborn

OBJECTIVE: Treatment of severe persistent pulmonary hypertension of the neoborn remains controversial and various modalities of treatment have been tried. This study was performed to evaluate the effect of magnesium sulphate (MgSO4) as a treatment of persistent pulmonary hypertension of the neoborn (PPHN) in full term babies.

METHODS: This study was carried out in the Maternity and Children's Hospital, Jeddah, Kingdom of Saudi Arabia from January 1998 to 2000. A non-randomized study in 8 neoborn babies who where admitted to the Intensive Care Unit and diagnosis of PPHN based on echocardiogram was conducted to assess the efficacy of MgSO4 8% dilution in a loading dose of 200mg/kg followed by a maintenance dose of 20-100mg/kg/hour. No other vasodilators were given, patients were not hyperventilated. The aim was to keep magnesium levels 3.5-5.5mgmmol/l.

RESULTS: Seven out of 8 patients showed marked improvement in partial pressure oxygen at 6 hours and maximum improvement at 24 hours. The same improvement noticed in peak inspiratory pressure, and ventilatory time support.

CONCLUSION: Results suggests that MgSO4 may be considered as an alternative treatment in PPHN when no other modalities are available as it is a non aggressive and low cost treatment.