Management of Persistent Pulmonary Hypertension in Preterm Infants
Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been...
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| Format: | Article |
| Language: | English |
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Korean Society of Neonatology
2021-02-01
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| Series: | Neonatal Medicine |
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| Online Access: | http://www.neo-med.org/upload/pdf/nm-2021-28-1-1.pdf |
| _version_ | 1819277635879960576 |
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| author | Byong Sop Lee |
| author_facet | Byong Sop Lee |
| author_sort | Byong Sop Lee |
| collection | DOAJ |
| description | Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygencarrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators. |
| first_indexed | 2024-12-23T23:59:15Z |
| format | Article |
| id | doaj.art-5f542501930c4a65beed219874785c0b |
| institution | Directory Open Access Journal |
| issn | 2287-9412 2287-9803 |
| language | English |
| last_indexed | 2024-12-23T23:59:15Z |
| publishDate | 2021-02-01 |
| publisher | Korean Society of Neonatology |
| record_format | Article |
| series | Neonatal Medicine |
| spelling | doaj.art-5f542501930c4a65beed219874785c0b2022-12-21T17:25:10ZengKorean Society of NeonatologyNeonatal Medicine2287-94122287-98032021-02-012811610.5385/nm.2021.28.1.11025Management of Persistent Pulmonary Hypertension in Preterm InfantsByong Sop Lee0 Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaPersistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygencarrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.http://www.neo-med.org/upload/pdf/nm-2021-28-1-1.pdfpersistent fetal circulation syndromehypertension, pulmonarynitric oxideinfant, prematurepremature rupture of fetal membrane |
| spellingShingle | Byong Sop Lee Management of Persistent Pulmonary Hypertension in Preterm Infants Neonatal Medicine persistent fetal circulation syndrome hypertension, pulmonary nitric oxide infant, premature premature rupture of fetal membrane |
| title | Management of Persistent Pulmonary Hypertension in Preterm Infants |
| title_full | Management of Persistent Pulmonary Hypertension in Preterm Infants |
| title_fullStr | Management of Persistent Pulmonary Hypertension in Preterm Infants |
| title_full_unstemmed | Management of Persistent Pulmonary Hypertension in Preterm Infants |
| title_short | Management of Persistent Pulmonary Hypertension in Preterm Infants |
| title_sort | management of persistent pulmonary hypertension in preterm infants |
| topic | persistent fetal circulation syndrome hypertension, pulmonary nitric oxide infant, premature premature rupture of fetal membrane |
| url | http://www.neo-med.org/upload/pdf/nm-2021-28-1-1.pdf |
| work_keys_str_mv | AT byongsoplee managementofpersistentpulmonaryhypertensioninpreterminfants |