Nitric Oxide and Endothelin in the Developing Pulmonary Circulation: Physiologic and Clinical Implications

  • Steven H. Abman
  • John P. Kinsella
  • Jean-Christophe Mercier
Part of the Clinical Physiology Series book series (CLINPHY)

Abstract

Within minutes after birth, pulmonary vascular resistance (PVR) rapidly falls from high fetal levels. This allows pulmonary blood flow to increase nearly tenfold and enables the lung to assume its postnatal role in gas exchange. Failure of the pulmonary circulation to successfully achieve and sustain this decrease in PVR causes severe hypoxemia in many neonatal cardiopulmonary disorders, which are referred to as the syndrome persistent pulmonary hypertension of the newborn (PPHN). Mechanisms leading to severe pulmonary hypertension after birth are poorly understood, but they include altered pulmonary vascular reactivity and structure. Persistent pulmonary hypertension of the newborn is a major clinical problem, contributing substantially to morbidity and mortality in both full-term and premature neonates. An understanding of basic mechanisms that underlie normal development of the pulmonary circulation in utero and that contribute to the marked pulmonary vasodilation during the normal transition at birth may provide insight into PPHN and related disorders.

Keywords

Surfactant Superoxide Prostaglandin NADPH Estradiol 

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Copyright information

© American Physiological Society 1999

Authors and Affiliations

  • Steven H. Abman
  • John P. Kinsella
  • Jean-Christophe Mercier

There are no affiliations available

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