Surfactant phosphatidylcholine metabolism in neonates with meconium aspiration syndrome

Janssen, Daphne J.; Carnielli, Virgilio P.; Cogo, Paola; Bohlin, Kajsa; Hamvas, Aaron; Luijendijk, I. H. T.; Bunt, Jan Erik H.; Tibboel, Dick; Zimmermann, Luc J. I.

doi:10.1016/j.jpeds.2006.07.027

Cited by 27 publications

(9 citation statements)

References 32 publications

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“…After verification via repeated cardiac ultrasound scans, patients were initially treated with inhaled nitric oxide according to the standard departmental protocol, but eventually had to be placed on venoarterial ECMO to maintain sufficient oxygenation. Criteria for ECMO in our institution have been published in prior publications describing different aspects of pharmacotherapy during ECMO 8–10. After written parental consent, we included 11 patients who had undergone ECMO with PH who had an arterial line during their stay in the intensive care unit (ICU).…”

Section: Methodsmentioning

confidence: 99%

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Ahsman

Witjes

Wildschut

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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SIL pharmacokinetics are highly variable in post-ECMO neonates and infants. In a median patient, the current dose regimen of 0.5-2.0 mg/kg four times a day leads to an exposure comparable to the recommended adult dose of 20 mg four times a day. Careful dose titration, based on efficacy and the occurrence of hypotension, remains necessary. Follow-up research should include appropriate pharmacodynamic endpoints, with a population pharmacokinetic/pharmacodynamic analysis to assign a suitable exposure window or target concentration.

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Section: Methodsmentioning

confidence: 99%

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Ahsman

Witjes

Wildschut

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…Meconium has an extremely high surface tension [116], inhibits surfactant function [11,66,98,132] and causes pneumonitis with direct toxicity to alveolar type II cells [68,109]. Furthermore, we have recently found decreased alveolar surfactant content and synthesis in infants with MAS [73].…”

Section: Meconium Aspiration Syndrome (Mas)mentioning

confidence: 99%

What’s new in surfactant?

Been

Zimmermann

2007

Eur J Pediatr

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“…Meconium aspiration syndrome (MAS) is a common severe respiratory disease in full term newborns and frequently results in inactivation of surfactant since meconium directly inhibits surfactant function [40]. Pneumothorax, change of fetal heart beat pattern and asphyxia are the most important risk factors associated with MAS which lead to the development of PPHN.…”

Section: Meconium Aspiration Syndromementioning

confidence: 99%

Persistent Pulmonary Hypertension of the Newborn: Therapeutical Approach

Latini

Vecchio²,

Felice³

et al. 2008

MRMC

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Persistent pulmonary hypertension of the newborn (PPHN), is defined as a failure of the pulmonary vasculature to relax at birth and consequently of the normal adaptation to extra uterine life of the fetal heart/lung system, resulting in hypoxemia. This condition, occurs in about 1-2 newborns per 1000 live births and despite significant improvements in treatment it is associated with substantial infant mortality and morbidity. Over the years wider application of inhaled nitric oxide (iNO) therapy and improved ventilation strategies including surfactant, high-frequency oscillatory ventilation has led to a decrease in the need for invasive life-sustaining therapies such as extracorporeal membrane oxygenation (ECMO). Mortality rate varies from 10 to 20 % of affected newborns in developed countries, but it is much higher when PPHN is refractory to the above reported therapies or when they are not available. As a consequence, development of new therapeutic strategies for severe PPHN is crucial. In particular, recent studies seem to show that sildenafil, a phosphodiesterase inhibitor type 5 that selectively reduces pulmonary vascular resistance may be a useful therapeutic adjunct to critically ill neonates with PPHN.

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Surfactant phosphatidylcholine metabolism in neonates with meconium aspiration syndrome

Cited by 27 publications

References 32 publications

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

What’s new in surfactant?

Persistent Pulmonary Hypertension of the Newborn: Therapeutical Approach

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