ABSTRACT
The burden of hypoxemic respiratory failure (HRF) is not well characterized in neonatal literature, primarily due to variability in the definition of HRF in the neonatal population and differences in the sampled populations. There is substantial overlap between the definitions of HRF and persistent pulmonary hypertension (PPHN) in the literature. The overall incidence of HRF/PPHN is estimated at approximately 1.8 per 1000 live births. HRF/PPHN occurs more commonly in males and follows a U-shaped curve across gestational age strata, with highest incidence/prevalence described in extremely preterm and near-term infants. Meconium aspiration syndrome and infection are the most common etiologies in term/near-term infants, while respiratory distress syndrome is the most common etiology in preterm infants. Overall mortality ranges from 10 to 20% in term/near-term infants and 30−50% in preterm infants with substantial variability in survival based on etiology. Re-hospitalization rates are three times higher in term/near-term infants with PPHN compared to those without PPHN during infancy. Severity and etiology of PPHN are the primary risks for increased post-discharge mortality or hospital readmission in the first year of life. PPHN is associated with higher risk of hearing impairment in term/near-term infants and visual impairment in preterm infants.
