Diagnosis and management of persistent pulmonary hypertension of the newborn

Lakshminrusimha, Satyan; Keszler, Martin

doi:10.1016/b978-0-323-76177-2.00043-x

Cited by 2 publications

(5 citation statements)

References 107 publications

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“…○ Conventional ventilator settings: PEEP 5 to 8 mm Hg, PIP 18 to 25 mm Hg, rate 30 to 40 breaths/min. 7 13…”

Section: Pulmonary Optimizationmentioning

confidence: 99%

“…Based on expert guidelines, we cautiously approach fluid administration as a bridge to establish inotropic and vasopressor support. 12 13…”

Section: Cardiovascular Optimizationmentioning

confidence: 99%

“…7 17 Table 2 depicts key aspects to consider in the echocardiographic evaluation of neonates with PPHN. 7 9 13 18 It is important to remember that severe PPHN should be associated with right-to-left (or bidirectional) shunting across both atrial and ductal shunts. However, left-to-right shunting at both the atrial and ductal levels suggests a primary lung disease pathology rather than PPHN.…”

Section: Diagnosis and Evaluationmentioning

confidence: 99%

“…Because the clinical presentations of CCHD lesions can be virtually indistinguishable from severe PPHN, always consider CCHD in the differential diagnosis of a neonate with PPHN. 13 For this reason, in any critically hypoxemic neonate, it is reasonable to consider empiric prostaglandin therapy until definitive diagnostic testing can be performed, especially for those with persistently low preductal PaO 2 despite early respiratory optimization. 7 9 In our experience, obstructed total anomalous pulmonary venous return (TAPVR) represents one of the most commonly missed CCHDs in neonates presenting with PPHN unresponsive to pulmonary vasodilator therapies.…”

Section: Introductionmentioning

confidence: 99%

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Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn

et al. 2021

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Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

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“…○ Conventional ventilator settings: PEEP 5 to 8 mm Hg, PIP 18 to 25 mm Hg, rate 30 to 40 breaths/min. 7 13…”

Section: Pulmonary Optimizationmentioning

confidence: 99%

“…Based on expert guidelines, we cautiously approach fluid administration as a bridge to establish inotropic and vasopressor support. 12 13…”

Section: Cardiovascular Optimizationmentioning

confidence: 99%

Section: Diagnosis and Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn

et al. 2021

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“…Subsequently, her condition stabilized. The patient continued taking sildenafil for long-term treatment of pulmonary hypertension and is currently thriving at eight months of age 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 .…”

mentioning

confidence: 99%