期刊
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
卷 106, 期 4, 页码 446-455出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/archdischild-2020-319705
关键词
cardiology; neonatology
类别
资金
- National Center for Advancing Translational Sciences, National Institutes of Health (NIH) [UL1 TR001860, KL2 TR001859]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH [1R21 1HD09923901]
- NIH [5R01 HD072929-09]
- NICHD
Systemic hypotension in persistent pulmonary hypertension of the newborn can lead to organ injury from poor perfusion and hypoxemia, requiring swift management tailored to each individual's physiology and echocardiographic findings.
In persistent pulmonary hypertension of the newborn (PPHN), the ratio of pulmonary vascular resistance to systemic vascular resistance is increased. Extrapulmonary shunts (patent ductus arteriosus and patent foramen value) allow for right-to-left shunting and hypoxaemia. Systemic hypotension can occur in newborns with PPHN due to variety of reasons, such as enhanced peripheral vasodilation, impaired left ventricular function and decreased preload. Systemic hypotension can lead to end organ injury from poor perfusion and hypoxaemia in the newborn with PPHN. Thus, it must be managed swiftly. However, not all newborns with PPHN and systemic hypotension can be managed the same way. Individualised approach based on physiology and echocardiographic findings are necessary to improve perfusion to essential organs. Here we present a review of the physiology and mechanisms of systemic hypotension in PPHN, which can then guide treatment.
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