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Survivors have high morbidity in the forms of neurodevelopmental and audiological impairment, cognitive delays, hearing loss, and a high rate of rehospitalization. The optimal approach to the management of PPHN remains controversial. Inhaled nitric oxide (iNO) is currently regarded as the gold standard therapy, but with as many as 30% of cases failing to respond, has not proven to be the single magic bullet. Given the complex pathophysiology of the disease, any such magic bullet is unlikely. A number of recent studies have suggested a role for specific phosphodiesterase (PDE) inhibitors in the management of PPHN. Sildenafil, a specific PDE5 inhibitor, appears the most promising of such agents. We aim to review the current status and limitations of iNO and the potential of PDE inhibitors in the management of PPHN. The reasons why caution is warranted before specific PDE5 inhibitors like sildenafil are labelled as potential magic bullets for PPHN will be discussed. The need for randomized\u2010controlled trials to determine the safety, efficacy, and long\u2010term outcome following treatment with sildenafil in PPHN is emphasized. Pediatr Pulmonol. 2003; 36:529\u2013535. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.10389","type":"journal-article","created":{"date-parts":[[2003,11,12]],"date-time":"2003-11-12T14:56:00Z","timestamp":1068648960000},"page":"529-535","source":"Crossref","is-referenced-by-count":71,"title":["Phosphodiesterase inhibitors for persistent pulmonary hypertension of the newborn: A 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