Nashwa Farouk Mohamed, Osama Abu El Fetouch Zaki El Feky, Heba Morsy Saad El Din El Ganady, Walid Abd Elatif Abd El Halim
Benha University.
Egypt
Journal of Neonatal-Perinatal Medicine
J Neonatal Perinatal Med 2025; 18: 246-254
DOI: 10.1177/19345798251325510
Abstract
Background: Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition resulting from elevated pulmonary vascular resistance, causing severe hypoxemia. Magnesium sulfate (MgSO4) is a potent vasodilator used in PPHN treatment, but its intravenous administration can cause systemic side effects. This study aims to compare the effects of nebulized and intravenous MgSO4 on oxygenation and hemodynamic parameters in neonates with severe PPHN.
Methods: This non-randomized controlled study was conducted on 40 mechanically ventilated neonates with severe PPHN at Benha University Hospitals. Neonates were divided into two groups: one received nebulized MgSO4 (NebMag, n = 20) and the other intravenous MgSO4 (IVMag, n = 20). Primary outcome was the change in Oxygenation Index (OI) at 12 and 24 hours. Secondary outcomes included changes in mean arterial pressure (MABP), serum magnesium levels, and vasoactive inotropic score (VIS).\
Results: Both groups showed improvements in oxygenation and ventilatory parameters. However, after 24 hours, the NebMag group had significantly lower OI (19.75 ± 2.9 vs 22.1 ± 2.19, p = 0.032) and higher PaO2 (69.45 ± 7.56 mmHg vs 60.75 ± 5.9 mmHg, p = 0.008). MABP was significantly higher and VIS was lower in the NebMag group at all time points. Serum magnesium levels were significantly lower in the NebMag group at 12 hours (3.6 ± 0.18 vs 1.2 ± 0.17 mmol/L, p < 0.001).
Conclusion: Nebulized MgSO4 may offer a safer alternative to intravenous administration, providing effective pulmonary vasodilation with fewer systemic side effects in neonates with PPHN.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Medical Therapy. Efficacy or Lack of Efficacy
Medical Therapy. Adverse Effects or Lack of Adverse Effects
Medical Therapy. Pharmacokinetics and Pharmacology
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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