Management of systemic hypotension in term infants with persistent pulmonary hypertension of the newborn: an illustrated review.

Autor:	Siefkes HM; Department of Pediatrics, UC Davis, Sacramento, California, USA hsiefkes@ucdavis.edu., Lakshminrusimha S; Department of Pediatrics, UC Davis, Sacramento, California, USA.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2021 Jul; Vol. 106 (4), pp. 446-455. Date of Electronic Publication: 2021 Jan 21.
DOI:	10.1136/archdischild-2020-319705
Abstrakt:	In persistent pulmonary hypertension of the newborn (PPHN), the ratio of pulmonary vascular resistance to systemic vascular resistance is increased. Extrapulmonary shunts (patent ductus arteriosus and patent foramen value) allow for right-to-left shunting and hypoxaemia. Systemic hypotension can occur in newborns with PPHN due to variety of reasons, such as enhanced peripheral vasodilation, impaired left ventricular function and decreased preload. Systemic hypotension can lead to end organ injury from poor perfusion and hypoxaemia in the newborn with PPHN. Thus, it must be managed swiftly. However, not all newborns with PPHN and systemic hypotension can be managed the same way. Individualised approach based on physiology and echocardiographic findings are necessary to improve perfusion to essential organs. Here we present a review of the physiology and mechanisms of systemic hypotension in PPHN, which can then guide treatment. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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