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Persistent pulmonary hypertension in the newborn

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https://www.readbyqxmd.com/read/30109814/therapeutic-hypothermia-for-moderate-and-severe-hypoxic-ischaemic-encephalopathy-in-newborns-using-low-cost-devices-ice-packs-and-phase-changing-material
#1
Y N Prashantha, P N Suman Rao, Saudamini Nesargi, B S Chandrakala, Kalyan Chakravarthy Balla, A Shashidhar
BACKGROUND: Different methods have been used for therapeutic hypothermia for neonates with moderate-to-severe hypoxic ischaemic encephalopathy (HIE). As standard cooling devices are expensive, there is a need to establish the safety and efficacy of low-cost devices such as ice packs (IP) and phase changing material (PCM). AIM: To assess the efficacy and safety of therapeutic hypothermia (TH) and the clinico-laboratory profile of neonates who underwent cooling with IP or PCM...
August 15, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/30083034/therapy-with-propylthiouracil-for-t3-predominant-neonatal-graves-disease-a-case-report
#2
Emi Hamajima, Masahiro Noda, Emina Nai, Satoka Akiyama, Yoji Ikuta, Natsuko Obana, Takahiro Kawaguchi, Kenta Hayashi, Kunihiro Oba, Tomohiro Yoshida, Tatsuo Katori, Masayuki Kokaji
This case report describes a male neonate with Graves' disease. The mother's pregnancy was complicated by poorly controlled Graves' disease. The neonate was diagnosed with thyroxine (T3)-predominant Graves' disease with low free triiodothyronine (T4) and high free T3 during antithyroid drug therapy. The patient also presented with persistent pulmonary hypertension of the newborn due to hyperthyroidism and airway stenosis caused by goiter. It was difficult to control thyroid function and maintain free T4 levels with inorganic iodine, thiamazole, and levothyroxine sodium hydrate...
2018: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/30072805/application-of-neonatologist-performed-echocardiography-in-the-assessment-and-management-of-persistent-pulmonary-hypertension-of-the-newborn
#3
REVIEW
Willem P de Boode, Yogen Singh, Zoltan Molnar, Ulf Schubert, Marilena Savoia, Arvind Sehgal, Philip Levy, Patrick McNamara, Afif El-Khuffash
Pulmonary hypertension contributes to morbidity and mortality in both the term newborn infant, referred to as persistent pulmonary hypertension of the newborn (PPHN), and the premature infant, in the setting of abnormal pulmonary vasculature development and arrested growth. In the term infant, PPHN is characterized by the failure of the physiological postnatal decrease in pulmonary vascular resistance that results in impaired oxygenation, right ventricular failure, and pulmonary-to-systemic shunting. The pulmonary vasculature is either maladapted, maldeveloped, or underdeveloped...
July 2018: Pediatric Research
https://www.readbyqxmd.com/read/30058708/study-on-sildenafil-combined-with-inhalational-nitric-oxide-therapy-on-the-curative-effects-and-serum-levels-of-hif-1%C3%AE-et-1-and-calcium-in-neonatal-pulmonary-hypertension
#4
G Liu, H-W Wu, Z-G Li
OBJECTIVE: To explore the effect of sildenafil combined with inhalational nitric oxide (NO) therapy on the curative effects and serum levels of hypoxia-inducible factor (HIF)-1α, endothelin-1 (ET-1), and calcium in persistent pulmonary hypertension of the newborn (PPHN). PATIENTS AND METHODS: Eighty-six patients with neonatal pulmonary hypertension treated in Xuzhou Children's Hospital from March 2015 to February 2016 were randomly divided into the observation group and control group, treated with sildenafil and sildenafil combined with inhalational NO, respectively...
July 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/30050261/a-clinical-study-on-congenital-diaphragmatic-hernia-in-neonates-our-institutional-experience
#5
Jayalaxmi Shripati Aihole, Aruna Gowdra, Deepak Javaregowda, Vinay Jadhav, M Narendra Babu, Ravidra Sahadev
Background: Congenital diaphragmatic hernia (CDH) is a complex developmental defect having a multifactorial etiology; i majority of cases (~80%), the cause is not known. Survival rates for patients with CDH have increased over the past decade with early prenatal detection and better postnatal management including surgery. Clinical profile and the outcome of 83 CDH neonates were studied and analyzed over a period of 12 years in our institute. Aims and Objectives: The clinical study was to analyze the clinical profile and outcome of CDH among the neonates in a tertiary care referral neonatal and pediatric center in Karnataka, India...
July 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/30046179/intravenous-epoprostenol-improves-oxygenation-index-in-patients-with-persistent-pulmonary-hypertension-of-the-newborn-refractory-to-nitric-oxide
#6
Kaashif Aqeeb Ahmad, Jesse Banales, Cody Lance Henderson, Susanne Erika Ramos, Katherine Marie Brandt, George Charles Powers
OBJECTIVES: Evaluate the short-term effects of IV epoprostenol in neonates with persistent pulmonary hypertension (PPHN) of the newborn. STUDY DESIGN: We reviewed 36 patients with inhaled nitric oxide (iNO) refractory PPHN placed on IV epoprostenol from 2010 to 2015. Patients were categorized as responders or non-responders (who either died or required extracorporeal membranous oxygenation). RESULTS: There were 15 responders and 21 non-responders...
July 25, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/30025669/clinical-characteristics-and-risk-factors-for-developing-pulmonary-hypertension-in-children-with-down-syndrome
#7
Douglas Bush, Csaba Galambos, D Dunbar Ivy, Steven H Abman, Kristine Wolter-Warmerdam, Francis Hickey
OBJECTIVES: To determine the incidence, characteristics of, and risk factors contributing to the development of pulmonary hypertension in children with Down syndrome. STUDY DESIGN: This retrospective, review of a large cohort (n = 1242) of children with Down syndrome receiving care at a specialized referral center evaluated clinical data and serial echocardiograms from a clinic database and electronic medical records. Pulmonary hypertension characteristics and comorbidities were reviewed...
July 17, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/30004838/persistent-pulmonary-hypertension-alters-epigenetic-characteristics-of-endothelial-nitric-oxide-synthase-gene-in-a-fetal-lamb-model
#8
Xingrao Ke, Hollis Johnson, Xigang Jing, Teresa Michalkiewicz, Yi-Wen Huang, Robert H Lane, Girija G Konduri
Decreased expression of endothelial nitric oxide synthase (eNOS), a key mediator of perinatal transition, characterizes persistent pulmonary hypertension of the newborn (PPHN) in neonates and a fetal lamb model; the mechanisms are unclear. We investigated whether increased DNA CpG methylation at the eNOS promoter in estrogen response elements (EREs) and altered histone code together contribute to decreased eNOS expression in PPHN. We isolated pulmonary artery endothelial cells (PAEC) from fetal lambs with PPHN induced by prenatal ductus arteriosus constriction from 128-136 days gestation or gestation matched twin controls...
July 13, 2018: Physiological Genomics
https://www.readbyqxmd.com/read/29954766/early-onset-necrotising-enterocolitis-in-association-with-congenital-diaphragmatic-hernia-in-a-term-baby
#9
Yu Han Koh, Rebecca Cooksey, Peter Prager
We report a case of a male, term newborn with known left congenital diaphragmatic hernia (CDH) who presented with circulatory compromise requiring maximal inotropic support in the first 24 hours of life. Repeat X-ray at 24 hours showed pneumatosis intestinalis. Emergency laparotomy was performed for suspected necrotising enterocolitis. The terminal ileum to the sigmoid colon were frankly necrotic with multiple perforations. Subtotal colectomy was performed. Although the recovery was protracted, the baby had a favourable outcome with progressive weight gain on follow-up at 3, 6 and 9 months of age...
June 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29949623/vasodilator-effects-of-dehydroepiandrosterone-dhea-on-fetal-pulmonary-circulation-an-experimental-study-in-pregnant-sheep
#10
Dyuti Sharma, Hélène Coridon, Estelle Aubry, Ali Houeijeh, Véronique Houfflin-Debarge, Rémi Besson, Philippe Deruelle, Laurent Storme
Persistent pulmonary hypertension (PPHN) remains a severe complication of the transition to extra-uterine life with significant morbidity and mortality in the newborns. Dehydroepiandrosterone (DHEA) represents a new pharmacological agent with vascular effects, including improvement of PPHN in several animal models. We hypothesized that DHEA could decrease pulmonary vascular resistance (PVR) in the pulmonary circulation of fetal sheep. We studied the effect of intravenous infusion of DHEA in fetal lambs using chronically instrumented sheep at 128 days of gestation...
2018: PloS One
https://www.readbyqxmd.com/read/29920641/the-practical-challenges-of-diagnosis-and-treatment-options-in-persistent-pulmonary-hypertension-of-the-newborn-a-developing-country-s-perspective
#11
Narongsak Nakwan
Persistent pulmonary hypertension of the newborn (PPHN) is a complication of several respiratory diseases characterized by an elevation in pulmonary vascular resistance with resultant right-to-left shunting of blood and severe hypoxemia in the neonatal period. PPHN carries a high rate of morbidity and mortality, particularly in limited-resource settings (low-income and/or developing country). Echocardiography remains the gold standard for diagnosis of PPHN. Modern therapies such as inhaled nitric oxide, high-frequency oscillatory ventilation, extracorporeal membrane oxygenation, and/or other pulmonary vasodilators agents can reduce the mortality rate of PPHN...
June 19, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29895840/altered-metabolites-in-newborns-with-persistent-pulmonary-hypertension
#12
Martina A Steurer, Scott Oltman, Rebecca J Baer, Sky Feuer, Liang Liang, Randi A Paynter, Larry Rand, Kelli K Ryckman, Roberta L Keller, Laura L Jelliffe-Pawlowski
BACKGROUND: There is an emerging evidence that pulmonary hypertension is associated with amino acid, carnitine, and thyroid hormone aberrations. We aimed to characterize metabolic profiles measured by the newborn screen (NBS) in infants with persistent pulmonary hypertension of the newborn (PPHN) METHODS: Nested case-control study from population-based database. Cases were infants with ICD-9 code for PPHN receiving mechanical ventilation. Controls receiving mechanical ventilation were matched 2:1 for gestational age, sex, birth weight, parenteral nutrition administration, and age at NBS collection...
June 12, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29843259/unusual-complication-of-fulminant-congenital-cytomegalovirus-infection
#13
T Arun Babu, Y Soliman, K Mohammad
Persistent pulmonary hypertension of newborn (PPHN) is a very rare manifestation of congenital cytomegalovirus (CMV) infection. PPHN associated with CMV can be severe but is usually transient and responds well to antiviral therapy. We report a rare case of PPHN that occurred in the setting of fulminant congenital CMV infection and successful treatment with antiviral therapy along with review of the very few cases reported in literature. A male appropriate for gestational Age (AGA) newborn developed rapidly progressive respiratory distress starting at 11 hours of life requiring ventilatory support and 100% oxygen...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29793868/lower-distending-pressure-improves-respiratory-mechanics-in-congenital-diaphragmatic-hernia-complicated-by-persistent-pulmonary-hypertension
#14
David Guevorkian, Sebastien Mur, Eric Cavatorta, Laurence Pognon, Thameur Rakza, Laurent Storme
OBJECTIVE: To investigate the effects of distending pressures on respiratory mechanics and pulmonary circulation in newborn infants with congenital diaphragmatic hernia (CDH) and persistent pulmonary hypertension (PPHN). STUDY DESIGN: In total, 17 consecutive infants of ≥37 weeks of gestational age with CDH and PPHN were included in this prospective, randomized, crossover pilot study. Infants were assigned randomly to receive 2 or 5 cmH2 O of positive end-expiratory pressure (PEEP) for 1 hour in a crossover design...
May 21, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29764471/inhaled-nitric-oxide-as-a-rescue-therapy-in-a-preterm-neonate-with-severe-pulmonary-hypertension-a-case-report
#15
Martina Busè, Francesco Graziano, Fabio Lunetta, Giorgio Sulliotti, Vincenzo Duca
BACKGROUND: Inhaled nitric oxide (iNO) has been approved for the treatment of persistent pulmonary hypertension of the newborn (PPHN) in term and near-term newborns. Its role in the management of persistent pulmonary hypertension in preterm infants is not clear. Although guidelines do not exist, some studies have shown that iNO could be used as a rescue therapy in preterm neonate with severe pulmonary hypertension. CASE PRESENTATION: We describe the case of a preterm neonate, born at 30 + 1 weeks of gestation, with hypoxic respiratory failure not responding to maximal conventional therapy...
May 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29712611/the-development-of-extracorporeal-membrane-oxygenation
#16
Don K Nakayama
Evolving from the development of heart-lung machines for open-heart surgery, extracorporeal membrane oxygenation has reemerged as a rescue modality for patients with acute respiratory failure that cannot be supported by conventional modes of ventilation. The history of extracorporeal membrane oxygenation begins with the discovery of heparin, fundamental to the success of extracorporeal circulation and membrane lungs. Engineers and scientists created suitable artificial membranes that allowed gas exchange while keeping gas and blood phases separate...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29681105/lethal-persistent-pulmonary-hypertension-of-the-newborn-in-bohring-opitz-syndrome
#17
Masaya Kibe, Satoshi Ibara, Hidehito Inagaki, Takema Kato, Hiroki Kurahashi, Toshiro Ikeda
Bohring-Opitz syndrome (BOS) is a rare disease with a number of characteristic features, including hypertelorism, prominent metopic suture, exophthalmos, cleft palate, abnormal posture, and developmental retardation. Here, we report a BOS patient presenting with lethal persistent pulmonary hypertension of the newborn (PPHN) and inspiratory respiratory failure. The female infant was treated with nitric oxide and vasodilator, which did not improve her condition. The inspiratory respiratory failure required management with deep sedation...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29502880/pulmonary-hypertension-associated-with-hypoxic-ischemic-encephalopathy-antecedent-characteristics-and-comorbidities
#18
Satyan Lakshminrusimha, Seetha Shankaran, Abbot Laptook, Scott McDonald, Martin Keszler, Krisa Van Meurs, Ronnie Guillet, Sanjay Chawla, Beena G Sood, Sonia Bonifacio, Abhik Das, Rosemary D Higgins
OBJECTIVE: To determine the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) associated with moderate or severe hypoxic ischemic encephalopathy (HIE). METHODS: We compared infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: the induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the "usual-care" arm (33.5°C for 72 hours) of the optimizing cooling trial...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29500505/restoring-fetal-circulation-as-a-means-of-bridging-treatment-prior-to-surgical-repair-of-anomalous-origin-of-the-right-pulmonary-artery-from-the-ascending-aorta-with-persistent-pulmonary-hypertension-of-the-newborn
#19
Aamisha Gupta, Dennis VanLoozen, Anastasios C Polimenakos, Kenneth A Murdison
Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital anomaly. Even more rarely reported is its presence in conjunction with persistent pulmonary hypertension of the newborn (PPHN). We present a case of a full-term infant, initially thought to have PPHN and later found to have anomalous origin of the right pulmonary artery from the ascending aorta. We discuss our management concept which included use of PgE1 infusion to restore fetal circulation prior to surgical treatment in this unique clinical scenario...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29465446/current-practices-and-attitudes-regarding-use-of-inhaled-nitric-oxide-in-the-nicu-results-from-a-survey-of-members-of-the-national-association-of-neonatal-nurse-practitioners
#20
Allyson Kayton, Paula Timoney, Lyn Vargo, Jose A Perez
BACKGROUND: Excessive supplemental oxygen exposure in the neonatal intensive care unit (NICU) can be associated with oxygen-related toxicities, which can lead to negative clinical consequences. Use of inhaled nitric oxide (iNO) can be a successful strategy for avoiding hyperoxia in the NICU. iNO selectively produces pulmonary vasodilation and has been shown to improve oxygenation parameters across the spectrum of disease severity, from mild to very severe, in neonates with hypoxic respiratory failure associated with persistent pulmonary hypertension of the newborn...
April 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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