Persistent pulmonary hypertension of the newborn
| Autor: | Judy L. Aschner, Mamta Fuloria |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Alkalosis Hypertension Pulmonary medicine.medical_treatment Models Biological Hypoxemia Diagnosis Differential 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine medicine Extracorporeal membrane oxygenation Humans 030212 general & internal medicine Adaptation to extrauterine life Hypoxia Cyanosis business.industry Infant Newborn Metabolic acidosis medicine.disease Combined Modality Therapy Bosentan 3. Good health medicine.anatomical_structure Neurodevelopmental Disorders Anesthesia Practice Guidelines as Topic Pediatrics Perinatology and Child Health Circulatory system Vascular resistance Cardiology medicine.symptom business medicine.drug |
| Zdroj: | Seminars in Fetal and Neonatal Medicine. 22:220-226 |
| ISSN: | 1744-165X |
| DOI: | 10.1016/j.siny.2017.03.004 |
| Popis: | Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography. Management strategies include optimal lung recruitment and use of surfactant in patients with parenchymal lung disease, maintaining optimal oxygenation and stable blood pressures, avoidance of respiratory and metabolic acidosis and alkalosis, and pulmonary vasodilator therapy. Extracorporeal membrane oxygenation is considered when medical management fails. Although mortality associated with PPHN has decreased significantly with improvements in medical care, there remains the potential risk for neurodevelopmental disability which warrants close follow-up of affected infants after discharge. |
| Databáze: | OpenAIRE |
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