Caregiver holding newborn's tiny feet between its fingers while in the hospital.

Persistent Pulmonary Hypertension of the Newborn (PPHN)

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If your newborn struggles to breathe, turns blue or feels cold right after birth, your whole world may feel like it’s coming to a screeching halt.

When this happens, your baby could have a condition called persistent pulmonary hypertension of the newborn (PPHN). You may also hear your provider call it “persistent pulmonary hypertension of the neonate” or “persistent fetal circulation syndrome.” All these names mean the same thing — your new baby needs help breathing.

Cleveland Clinic Children’s expert newborn critical care providers spring into action when your new baby shows signs of PPHN after delivery. We can quickly find out what’s causing these problems, make a diagnosis and start treatment right away.

Why Choose Cleveland Clinic Children’s for PPHN Care?

Trusted experts:

We have Level IV (the highest level) and Level III neonatal intensive care units (NICUs) to treat newborns with even the most complex health conditions — like PPHN. You can rely on our experienced team to give your baby experienced, compassionate care. Meet our team.

Comfort and convenience:

You and your family play an important role in your child’s care while they stay in our NICU. And we make it easy for you to be there for them — from 24/7 visitation hours to bedside meetings with providers. And when your baby is ready to leave the hospital, you’ll stay with them in one of our transition rooms so you can get more comfortable with caring for them.

Specialized knowledge:

Your child may need different levels of breathing support and oxygenation throughout treatment. Cleveland Clinic Children’s newborn healthcare experts offer every possible treatment for severe PPHN to open up restricted blood vessels and help your baby get the oxygen they need.

Patient-centered care:

Even after your child leaves the hospital, we continue to keep an eye on them. We’ll carefully watch their growth and development with our NICU follow-up care. This includes regular visits and testing after your baby leaves the hospital until around age 2.

Virtual visits:

Not all follow-up visits need to be in person. You can meet with your baby’s providers with virtual visits from the comfort of your home to update them on progress and talk about the next steps. All you need is a smartphone, computer or tablet and internet access.

National recognition:

Cleveland Clinic Children’s is a trusted healthcare leader. We’re recognized through the U.S. for our expertise and care.

Diagnosing Persistent Pulmonary Hypertension in the Newborn at Cleveland Clinic Children’s

If your child is born with PPHN, the blood vessels in their lungs aren’t wide enough for oxygen and blood to flow easily to their brain and other organs. This can happen for many reasons, like infections, lack of oxygen before or during birth and abnormal lung development.

We typically see this condition in babies born at 34 weeks or more, including full-term newborns. Your baby may have PPHN if they show signs at birth (or soon after), like:

Rapid or slow breathing.
Rapid heart rate.
Bluish skin.
Cold hands and feet.
Decreased activity.
Not feeding well.
Low blood pressure.
Low blood oxygen levels.

When we see these warning signs, we’ll do a few tests to help quickly confirm a diagnosis, then we’ll start personalized treatment right away.

Testing for PPHN

Imaging tests, like an echocardiogram (echo) and chest X-ray, show us your baby’s lungs, heart and blood vessels. We’ll also measure your child’s blood oxygen level and do several blood tests.

Meet Our PPHN Team

Newborns with breathing conditions like PPHN may need the care of providers from different specialties. Cleveland Clinic Children’s team-based approach to treatment means they’ll have handpicked experts on their side — ones selected based on your child’s unique needs. Their care team could include:

Providers Who Treat PPHN

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Treating Persistent Pulmonary Hypertension in the Newborn at Cleveland Clinic Children’s

Left untreated, PPHN is life-threatening. The quicker we act, the better the results. So, our NICU providers work fast to help your child get oxygen. They’ll also adjust the blood pressure in their lungs.

The treatments your newborn gets will depend on how severe their PPHN diagnosis is. We may:

Give them oxygen.
Use a special, fast ventilator to help them breathe.
Give them blood pressure medication through their vein (intravenously or IV).
Use nitric oxide to open up narrow pulmonary blood vessels.
Put them on a temporary heart-lung bypass machine (extracorporeal membrane oxygenation or ECMO).

Your child will likely stay in the NICU during and after treatment so we can keep an eye on them. How long they stay in the NICU will depend on their unique needs. Parents have 24/7 visitation, so you can stay by their side the whole time. We encourage family-centered rounds, where you join bedside meetings and updates with your child’s care team each day.

What to expect after treatment

As your newborn gets ready to leave the hospital, we’ll likely move them to a transition room. Here, you’ll learn how to care for them at home from our team of compassionate, experienced providers.

And for up to two years, your baby will have regular check-ups and testing. We want to be sure they (and their lungs) are growing and developing as they should.

Taking the Next Step

Having a baby comes with all kinds of emotions. But when your newborn is diagnosed at birth with a serious lung condition, worry can move to the top of the list. We’re here to help you through every step and with every concern that comes with a persistent pulmonary hypertension of the newborn diagnosis. Our compassionate and expert team of pediatric healthcare providers moves quickly to confirm a diagnosis and start treatment to help your baby (and you) breathe easier.