Abstract
Persistent pulmonary hypertension of the newborn (PPHN) remains a serious disorder with significant mortality and long term morbidity. Inhaled nitric oxide is the only approved vasodilator therapy in neonates, but 40% of infants are non-responders. Recent biological evidence has enhanced our understanding of the cellular mechanisms involved in cardiopulmonary transition at birth, paving the way for potential alternate therapies as published in recent reviews. Optimal clinical care of infants with PPHN necessitates a comprehensive understanding and evaluation of cardiopulmonary hemodynamics. Targeted neonatal echocardiography (TnECHO) is increasingly being implemented to guide clinical decision making. The purpose of this review is to outline the role of TnECHO in better defining the cardiopulmonary physiology in PPHN and its application in clinical practice. In addition we briefly review the physiology, pathogenesis and novel therapeutic agents currently under investigation for management of PPHN.
Keywords: Cardiovascular physiology, hemodynamics, persistent pulmonary hypertension of the newborn, targeted neonatal echocardiography, vasodilator
Current Pediatric Reviews
Title:Persistent Pulmonary Hypertension of the Newborn: Physiology, Hemodynamic Assessment and Novel Therapies
Volume: 9 Issue: 1
Author(s): Amish Jain and Patrick J. McNamara
Affiliation:
Keywords: Cardiovascular physiology, hemodynamics, persistent pulmonary hypertension of the newborn, targeted neonatal echocardiography, vasodilator
Abstract: Persistent pulmonary hypertension of the newborn (PPHN) remains a serious disorder with significant mortality and long term morbidity. Inhaled nitric oxide is the only approved vasodilator therapy in neonates, but 40% of infants are non-responders. Recent biological evidence has enhanced our understanding of the cellular mechanisms involved in cardiopulmonary transition at birth, paving the way for potential alternate therapies as published in recent reviews. Optimal clinical care of infants with PPHN necessitates a comprehensive understanding and evaluation of cardiopulmonary hemodynamics. Targeted neonatal echocardiography (TnECHO) is increasingly being implemented to guide clinical decision making. The purpose of this review is to outline the role of TnECHO in better defining the cardiopulmonary physiology in PPHN and its application in clinical practice. In addition we briefly review the physiology, pathogenesis and novel therapeutic agents currently under investigation for management of PPHN.
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Cite this article as:
Jain Amish and J. McNamara Patrick, Persistent Pulmonary Hypertension of the Newborn: Physiology, Hemodynamic Assessment and Novel Therapies, Current Pediatric Reviews 2013; 9 (1) . https://dx.doi.org/10.2174/1573396311309010013
DOI https://dx.doi.org/10.2174/1573396311309010013 |
Print ISSN 1573-3963 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6336 |
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