Oxygen Targets in Neonatal Pulmonary Hypertension

Lakshminrusimha, Satyan; Abman, Steven H.

doi:10.1016/j.clp.2023.12.003

Cited by 2 publications

(2 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, because most BPD-PH infants are diagnosed after 36 weeks PMA, the use of oxygen should be less of a concern with relation to retinopathy of prematurity. For the majority of term, uncomplicated BPD-PH infants (i.e., without pulmonary vein stenosis or cardiac shunts), targeting saturations of 92-95% is reasonable [5,61,69]. Some guidelines have advocated for the use of 95% saturation as a target in infants with established BPD-PH to avoid hypoxemic stress on the pulmonary vasculature, although no trial has tested this saturation target within this population [70,71].…”

Section: Management Of Chronic Respiratory Failure: Oxygenmentioning

confidence: 99%

“…iNO binds to soluble guanylate cyclase in the pulmonary vascular endothelial cells, stimulating the conversion of guanosine triphosphate to cyclic guanosine monophosphate (cGMP), which, as a second messenger, prompts the relaxation of smooth muscle cells in blood vessel walls. Exogenous iNO is often used in infants with other forms of pulmonary arterial hypertension, particularly in the setting of persistent pulmonary hypertension of the newborn (PPHN) [18,69]. Given the effect of nitric oxide in vasodilation, iNO is often used beyond the perinatal period as an acute, temporary therapy for the BPD-PH infant.…”

Section: Lack Of Approved Ph Therapies and Lack Of Data In This Popul...mentioning

confidence: 99%

See 1 more Smart Citation

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Varghese,

Altit,

Gubichuk

et al. 2024

JCM

View full text Add to dashboard Cite

Advances in perinatal intensive care have significantly enhanced the survival rates of extremely low gestation-al-age neonates but with continued high rates of bronchopulmonary dysplasia (BPD). Nevertheless, as the survival of these infants improves, there is a growing awareness of associated abnormalities in pulmonary vascular development and hemodynamics within the pulmonary circulation. Premature infants, now born as early as 22 weeks, face heightened risks of adverse development in both pulmonary arterial and venous systems. This risk is compounded by parenchymal and airway abnormalities, as well as factors such as inflammation, fibrosis, and adverse growth trajectory. The presence of pulmonary hypertension in bronchopulmonary dysplasia (BPD-PH) has been linked to an increased mortality and substantial morbidities, including a greater susceptibility to later neurodevelopmental challenges. BPD-PH is now recognized to be a spectrum of disease, with a multifactorial pathophysiology. This review discusses the challenges associated with the identification and management of BPD-PH, both of which are important in minimizing further disease progression and improving cardiopulmonary morbidity in the BPD infant.

show abstract

Section: Management Of Chronic Respiratory Failure: Oxygenmentioning

confidence: 99%

Section: Lack Of Approved Ph Therapies and Lack Of Data In This Popul...mentioning

confidence: 99%

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Varghese,

Altit,

Gubichuk

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?

Sankaran,

Li,

Lakshminrusimha

2024

Children

Self Cite

View full text Add to dashboard Cite

Hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality among term newborns globally. Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome (MAS) and HIE. Simultaneous occurrence of MAS and HIE is a perilous combination for newborns due to the risk of persistent pulmonary hypertension of the newborn (PPHN). Moreover, therapeutic hypothermia (TH), which is the current standard of care for the management of HIE, may increase pulmonary vascular resistance (PVR) and worsen PPHN. Infants with MAS and HIE require close cardiorespiratory and hemodynamic monitoring for PPHN. Therapeutic strategies, including oxygen supplementation, ventilation, use of surfactant, inhaled nitric oxide and other pulmonary vasodilators, and systemic vasopressors, play a critical role in the management of PPHN in MAS, HIE, and TH. While TH reduces death or disability in infants with HIE, infants with MAS and HIE undergoing TH need close hemodynamic monitoring for PPHN.

show abstract

Oxygen Targets in Neonatal Pulmonary Hypertension

Cited by 2 publications

References 66 publications

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?

Contact Info

Product

Resources

About