How to treat persistent pulmonary hypertension of a newborn?
Patient's Query
Hello doctor,
We have an 84-hour-old daughter, and an echocardiogram was done when she was 22-hour-old. In the report, the child cardiologist found a small PFO, a tiny PDA, a small PM VSD, and severe PPHN, GW and BVR. He advised Furoped to be started after two weeks with one drop once a day and after four weeks, one drop twice a day. Is it safe to use the medicine for our daughter with the said problem, or should the medication be started immediately? Kindly help.
Hi,
Welcome to icliniq.com.
As per the limited information, a small patent foramen ovale (PFO) usually closes on its own and does not require any intervention. It is always a wait-and-watch plan for a small patent ductus arteriosus (PDA) as it may close in most cases if tiny. Small perimembranous ventricular septal defects (VSD) need regular follow-up. So the only thing to be taken care of at this time is severe persistent pulmonary hypertension of the newborn (PPHN). Furoped (Torasemide) is given to decrease the load on the heart. It is a diuretic. I believe you should follow the neonatologist's advice and have a regular follow-up. Your daughter is low birth weight. Is she premature or full term? Also, is she having normal breathing? Is she feeding well? Is she passing urine well? I expect that with severe PPHN, your daughter will still be in the hospital under observation.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the response. Should we start Furoped drops from today or not? Kindly suggest.
Hi,
Welcome back to icliniq.com.
I suggest not to start it right now. Instead, stick to the suggestion of your neonatologist, who has examined the baby physically. But get her checked once before starting this medication at two weeks of her age. Another thing - have they advised you anything else for severe persistent pulmonary hypertension of the newborn (PPHN)? They should keep the baby under observation till the PPHN is at safe levels.
Thank you.
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