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Persistent Pulmonary Hypertension of the Newborn

  • Chapter
Role of Nitric Oxide in Sepsis and ADRS

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 24))

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Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a complex disorder associated with a wide array of cardiopulmonary diseases. PPHN is characterized by marked pulmonary hypertension and altered vasoreactivity, leading to right-to-left shunting of blood across the patent ductus arteriosus and foramen ovale [1–3]. Critical hypoxemia results from extrapulmonary shunting, and is often poorly responsive to high inspired oxygen concentrations and pharmacologic vasodilation [4]. However, the PPHN syndrome is often associated with severe parenchymal lung disease (e.g. lung hypoplasia, meconium aspiration pneumonitis, bacterial pneumonia, and surfactant deficiency) which causes intrapulmonary shunting and further complicates the clinical course and response to treatment. Moreover, disturbances in cardiac performance, hypovolemia, and decreased systemic vascular resistance may compromise the tenuous balance between the systemic and pulmonary circulation in PPHN. Thus, effective therapy for neonatal hypoxemic respiratory failure complicated by extrapulmonary veno-arterial admixture requires vigilant attention to all aspects of these cardiopulmonary interactions (Fig. 1).

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Authors
  1. J. C. Mercier
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  2. A. T. Dinh-Xuan
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  3. S. H. Abman
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Editor information

Editors and Affiliations

  1. Department of Surgery, Beth Israel Hospital, 330 Brookline Avenue, 02215, Boston, MA, USA

    M. P. Fink

  2. Department of Anesthesiology and Intensive Care, Lariboisière University Hospital, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Didier Payen

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© 1995 Springer-Verlag Berlin Heidelberg

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Mercier, J.C., Dinh-Xuan, A.T., Abman, S.H. (1995). Persistent Pulmonary Hypertension of the Newborn. In: Fink, M.P., Payen, D. (eds) Role of Nitric Oxide in Sepsis and ADRS. Update in Intensive Care and Emergency Medicine, vol 24. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79920-4_23

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  • DOI: https://doi.org/10.1007/978-3-642-79920-4_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79922-8

  • Online ISBN: 978-3-642-79920-4

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