Persistent Pulmonary Hypertension of the Newborn

NeoReviews
Satyan Lakshminrusimha, Martin Keszler

Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is often secondary to parenchymal lung disease (such as meconium aspiration syndrome) or lung hypoplasia (with congenital diaphragmatic hernia) but can also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance, resulting in right-to-left shunting of blood and hypoxemia. The diagnosis of PPHN is based on clinical evidence of labile hypoxemia often associated with differential cyanosis and confirmed by echocardiography. Lung volume recruitment with optimal use of positive end-expiratory pressure or mean airway pressure and/or surfactant is very important in secondary PPHN due to parenchymal lung disease. Other management strategies include optimal oxygenation, avoiding respiratory and metabolic acidosis, blood pressure stabilization, sedation, and pulmonary vasodilator therapy. Failure of these measures leads to consideration of extracorporeal membrane oxygenation, although this rescue therapy is needed less frequently with advances in medical management. Randomized clinical trials with long-term follow-up are required to evaluate various therapeutic strategies in PPHN.

Associated Clinical Trials

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Citations

Jan 19, 2016·Seminars in Perinatology·Satyan LakshminrusimhaCorinne L Leach
May 10, 2016·Journal of Magnetic Resonance Imaging : JMRI·Onur AfacanSimon K Warfield
Aug 10, 2017·Children·Bobby Mathew, Satyan Lakshminrusimha
Aug 6, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Ziad AlhassenRita M Ryan
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Mar 24, 2017·Maternal Health, Neonatology and Perinatology·Praveen Kumar ChandrasekharanSatyan Lakshminrusimha
Dec 5, 2019·Clinical Medicine Insights. Pediatrics·Mahdi AlsaleemVasantha Hs Kumar
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Jul 2, 2019·NeoReviews·Gillian BrennanChristine Carlos
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Jan 23, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Heather M Siefkes, Satyan Lakshminrusimha
Oct 13, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Amish JainPatrick J McNamara
Jan 30, 2021·Seminars in Fetal & Neonatal Medicine·Praveen ChandrasekharanSteven H Abman
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Aug 7, 2021·Clinics in Perinatology·Yogen Singh, Satyan Lakshminrusimha

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