Alveolar capillary dysplasia--a cause of persistent pulmonary hypertension unresponsive to a second course of extracorporeal membrane oxygenation

Recurrence of persistent pulmonary hypertension of the newborn (PPHN) after successful extracorporeal membrane oxygenation (ECMO) therapy has been reported.1,2 Payne1 treated the recurrence of PPHN with conventional therapy, and two of his three patients recovered. De La Cruz2 reported using a second course of ECMO to treat a recurrence of pulmonary hypertension and respiratory failure of other origins in three patients. Two of the three infants survived. As of January 13, 1993, there were a total of 47 infants reported to the Extracorporeal Life Support Organization (ELSO) who had undergone a second course of ECMO.3 The two most common diagnoses among these infants were congenital diaphragrnatic hernia and PPHN.