Timberline et al reported a scoring tool for evaluating the severity of Persistent Pulmonary Hypertension of newborn (PPHN). This has 2 components, one based on oxygenation and one for echocardiographic findings. The authors are from the University of Virginia and University of California Davis.
Patient selection: persistent pulmonary hypertension of newborn (PPHN)
Parameters:
(1) oxygenation source: nasal cannula, CPAP, noninvasive or invasive ventilation
(2) liters per minute (LPM) if on cannula
(3) FIO2 if on cannula
(4) arterial line available
(5) oxygen saturation index (OSI), based on inspired oxygen, mean airway pressure and preductal SpO2
(6) oxygenation index (OI), based on inspired oxygen, mean airway pressure and PaO2
If nasal cannula (including high flow)
|
Liters per Minute
|
FIO2
|
Points
|
|
< 2
|
< 0.3
|
0
|
|
< 2
|
>= 0.3
|
1
|
|
>= 2
|
< 0.3
|
1
|
|
>= 2
|
>= 0.3
|
1
|
If CPAP, noninvasive or invasive ventilation:
|
Arterial Line
|
Oxygen Saturation Index (OSI)
|
Oxygenation Index (OI)
|
Points
|
|
no
|
< 5
|
NA
|
2
|
|
no
|
5 to 9.99
|
NA
|
3
|
|
no
|
10 to 14.99
|
NA
|
4
|
|
no
|
>= 15
|
NA
|
5
|
|
yes
|
NA
|
< 10
|
2
|
|
yes
|
NA
|
10 to 19.99
|
3
|
|
yes
|
NA
|
20 to 29.99
|
4
|
|
yes
|
NA
|
>= 30
|
5
|
Interpretation:
• minimum score: 0
• maximum score: 5
• The score is combined with echocardiogram score to generate the final score.
