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PPHN is secondary to impaired or delayed relaxation of the pulmonary vasculature associated with a diverse group of cardiopulmonary pathologies such as meconium aspiration syndrome (MAS), congenital diaphragmatic hernia (CDH), congenital pneumonia, hypoxic ischemic encephalopathy (HIE / perinatal asphyxia), premature prolonged rupture of membranes (pPROM), respiratory distress syndrome (RDS) and underlying or associated congenital heart disease (CHD) (5, 6)

However, during the chronic inflammation, the glial activation causes an increase of ROS production and other neurotoxic mediators, leading a neuronal damage [52]

By free radical clearance and inhibition of leukotriene and histamine production, ambroxol effectively attenuates inflammation from macrophages and neutrophils

No established upper limit exists because excess b12 excretes through kidneys without causing harm