Persistent pulmonary hypertension of the newborn

Mamta Fuloria, Judy L. Aschner

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalSeminars in Fetal and Neonatal Medicine
DOIs
StateAccepted/In press - 2017

Keywords

  • Bosentan
  • Hypoxemia
  • Milrinone
  • Nitric oxide
  • Prostacyclin
  • Sildenafil

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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