Ryan's Diagnosis is Pulmonary Hypertension

We received the results of Ryan's echocardiogram at about 2:45pm. The primary neonatologist explained that the report shows that Ryan does have the scariest (and what we were told was the least likely) of the possible issues going on, pulmonary hypertension. The doctor was very good about answering our questions and describing in detail what this diagnosis means.
I'll try to explain it, but many of my friends have much more knowledge in this area than I do, so please feel free to post corrections or a better explanation. Basically when a baby is growing in the womb since the lungs are not needed, the circulatory system shunts oxygenated blood to other parts of the body. Once the baby is born, the entire circulatory system's flow changes such that oxygenated blood flows to all parts of the body that require it (including the vessels in the lungs). This transition of flow in the circulatory system usually takes between 5 minutes and 5 hours to occur in most newborns. Pulmonary hypertension results when the bloodflow does not change, and the vessels in the lungs do not dilate nor receive oxygenated blood as they are supposed to (the baby's circulatory system behaves as though he is still in the womb even once the lungs are needed after birth). http://www.healthsystem.virginia.edu/uvahealth/peds_hrnewborn/pph.cfm
There are 3 different treatment options depending upon the severity of the symptoms that a baby manifests. The first is to keep the baby at 100% oxygen for 12-24 hrs (oxygen is a vasodilator) with the hope that the circulatory system will start functioning as it should on its own. After remaining fully saturated with oxygen for some time, then weaning off the oxygen occurs at a slow pace (they had attempted to wean Ryan's oxygen supplement pretty aggressively last night and he didn't tolerate it well this morning). If his circulation doesn't resolve with this course of treatment, then the next step is to intubate him and he would be on a mechanical ventilator for 7-12 days, receive surfactant treatments for his lungs, and then try to be weaned off of the vent. If that doesn't work, then he would require ECMO (Extracorporeal Membrane Oxygenation) treatment which is only available in level 4 NICUs (we are at a level 3 NICU). The availability of this equipment and personnel trained to use it is what differentiates a level 3 and level 4 (highest) NICU. I shouldn't have, but did, look ECMO up online and now wish that I hadn't because it's very scary: http://oce.sph.unc.edu/phnceac/babyguide/ecmo.pdf
If this treatment were to be required, it is available at the children's hospital downtown.

After this explanation, I asked the doctor if the collapsed lung was a completely separate issue that was actually unrelated to the root cause of his respiratory issues. He confirmed that these complications are completely unrelated and both were originally explained to us as being very unlikely to occur. We've informed the nurses, but not yet the neonatologist, that it seems for our family oftentimes when a "very unlikely but serious" complication is a possibility, then count on us to experience it. Please pray that the first option for treatment is successful for Ryan. It would break my heart and be incredibly scary to have to see him be intubated and on a ventilator. Since the hood is still required, we cannot hold him, and he is still supposed to be very limited in stimulation. Hopefully I'll have some good news to post over the coming days.