pediatrics
Persistent Pulmonary Hypertension of the Newborn
Key Points
Prolonged hypoxia and/or acidosis or disorders that increase pulmonary blood flow cause smooth muscle hypertrophy in small pulmonary arteries, resulting in persistent pulmonary hypertension. Persistent pulmonary hypertension causes right-to-left shunting via the ductus arteriosus or a foramen ovale, resulting in intractable systemic hypoxemia; right-sided heart failure may develop. Confirm diagnosis by echocardiography. Give oxygen to dilate pulmonary vasculature, mechanical ventilation, inhaled nitric oxide, and, for severe cases, extracorporeal membrane oxygenation (ECMO). 