O Papel da Oxigenação por Membrana Extracorpórea (ECMO) no Manejo da Hipertensão Pulmonar Persistente do Recém-Nascido

Abstract

Persistent Pulmonary Hypertension of the Newborn (PPHN) is a severe condition that impedes adequate oxygenation of neonatal blood and is associated with high morbidity and mortality. It is characterized by persistent high pulmonary vascular resistance, extrapulmonary shunts, and severe hypoxemia due to genetic, inflammatory, and environmental factors. Conventional treatments include supplemental oxygen, optimized mechanical ventilation, and pharmacological agents such as inhaled nitric oxide and sildenafil. However, many neonates remain refractory, necessitating alternative approaches such as extracorporeal membrane oxygenation (ECMO). ECMO provides temporary cardiopulmonary support for neonates with severe respiratory failure and refractory hypoxemia, allowing the lungs and heart to recover. However, its use presents significant risks, including hemorrhagic and infectious complications. This study aims to review the literature on the use of ECMO in managing PPHN, evaluating its efficacy and safety compared to conventional treatments, and identifying knowledge gaps for future research. The methodology includes a systematic review of scientific articles, conferences, and technical reports. The results indicate that ECMO significantly improves survival rates in neonates with refractory PPHN, although it is associated with serious complications that require rigorous management. Follow-up studies show the need for early intervention programs to improve neurodevelopmental outcomes. The introduction of technological innovations and improved clinical practices has enhanced the safety and efficacy of ECMO. In conclusion, ECMO represents a critical intervention for neonates with refractory PPHN, necessitating further research to optimize its use and improve neonatal care.