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pulmonary hypertension in infants

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https://www.readbyqxmd.com/read/28521893/pulmonary-hypertension-in-infants-children-and-young-adults
#1
REVIEW
Georg Hansmann
Pulmonary hypertension (PH) in neonates, infants, children, adolescents, and young adults is a complex condition that can be associated with several cardiac, pulmonary, and systemic diseases contributing to morbidity and mortality. The underlying pulmonary hypertensive vascular disease (PHVD) is characterized by inflammation, pulmonary vascular remodeling, and angio-obliteration leading to elevated pulmonary arterial pressure and resistance, right ventricular dysfunction, left ventricular compression, and subsequent heart failure...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28494828/treatment-of-persistent-pulmonary-hypertension-of-the-newborn-use-of-pulmonary-vasodilators-in-term-neonates
#2
Caitlyn Luecke, Christopher McPherson
Persistent pulmonary hypertension of the newborn (PPHN) represents a challenging condition associated with significant morbidity. A successful transition from intrauterine to extrauterine life is contingent on adequate pulmonary vasodilation. Several pathophysiologies contribute to the failure of this cascade and may result in life-threatening hypoxia and acidosis in the newborn. Management includes optimal respiratory support, adequate sedation and analgesia, and support of vascular tone and cardiac function...
May 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28492159/iloprost-instillation-in-two-neonates-with-pulmonary-hypertension
#3
Sezin Unal, Selma Aktas, Meltem Aksu, Ibrahim M Hirfanoglu, Yildiz Atalay, Canan Turkyilmaz
Pulmonary hypertension may coexist with certain diseases in neonates. Iloprost inhalation is one of the treatments which cause selective pulmonary vasodilatation. Inhalation is not an easy way of drug administration in mechanically ventilated infants; as some exhibit desaturations during inhalation. Moreover, inhalation of drug requires cessation of mechanical ventilation, if patient is on high frequency oscillatory ventilation. We presented two patients with pulmonary hypertension; term baby with congenital diaphragmatic hernia and preterm baby with respiratory distress syndrome; who had iloprost instillation during mechanical ventilation treatment...
April 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28483819/short-term-and-long-term-outcomes-of-preterm-neonates-with-acute-severe-pulmonary-hypertension-following-rescue-treatment-with-inhaled-nitric-oxide
#4
Michelle Baczynski, Shannon Ginty, Dany E Weisz, Patrick J McNamara, Edmond Kelly, Prakeshkumar Shah, Amish Jain
OBJECTIVE: To describe short-term and long-term outcomes of preterm neonates with severe acute pulmonary hypertension (aPHT) in relation to response to rescue inhaled nitric oxide (iNO) therapy. DESIGN: Retrospective cohort studyover a 6 year period. SETTING: Tertiary neonatal intensive care unit. PATIENTS: 89 neonates <35 weeks gestational age (GA) who received rescue iNO for aPHT, including 62 treated at ≤3 days of age (early aPHT)...
May 8, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28472876/effect-of-inhaled-nitric-oxide-on-oxygen-therapy-mechanical-ventilation-and-hypoxic-respiratory-failure
#5
Dan L Stewart, Paul A Vogel, Brant Jarrett, Jim Potenziano
To assess the role of inhaled nitric oxide (iNO) in reducing the need for oxygen therapy, decreasing time on mechanical ventilatory support, and attenuating probability of hypoxic respiratory failure severity progression, we reviewed published reports of phase III iNO studies in neonates with hypoxic respiratory failure and pulmonary hypertension, as well as a novel post hoc analysis of data from the Clinical Inhaled Nitric Oxide Research Group Initiative (CINRGI) study population not been previously reported...
May 4, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28457522/lung-transplantation-for-flna-associated-progressive-lung-disease
#6
Lindsay C Burrage, R Paul Guillerman, Shailendra Das, Shipra Singh, Deborah A Schady, Shaine A Morris, Magdalena Walkiewicz, Marc G Schecter, Jeffrey S Heinle, Timothy E Lotze, Seema R Lalani, George B Mallory
OBJECTIVE: To describe a series of patients with pathogenic variants in FLNA and progressive lung disease necessitating lung transplantation. STUDY DESIGN: We conducted a retrospective chart review of 6 female infants with heterozygous presumed loss-of-function pathogenic variants in FLNA whose initial presentation was early and progressive respiratory failure. RESULTS: Each patient received lung transplantation at an average age of 11 months (range, 5-15 months)...
April 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28433214/maturational-patterns-of-systolic-ventricular-deformation-mechanics-by-two-dimensional-speckle-tracking-echocardiography-in-preterm-infants-over-the-first-year-of-age
#7
Philip T Levy, Afif El-Khuffash, Meghna D Patel, Colm R Breatnach, Adam T James, Aura A Sanchez, Cristina Abuchabe, Sarah R Rogal, Mark R Holland, Patrick J McNamara, Amish Jain, Orla Franklin, Luc Mertens, Aaron Hamvas, Gautam K Singh
BACKGROUND: The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. METHODS: In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA)...
April 19, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28419544/adults-born-preterm-a-review-of-general-health-and-system-specific-outcomes
#8
REVIEW
Tonse N K Raju, A Sonia Buist, Carol J Blaisdell, Marva Moxey-Mims, Saroj Saigal
In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28411000/meconium-aspiration-or-respiratory-distress-associated-with%C3%A2-meconium-stained-amniotic-fluid
#9
REVIEW
Nestor E Vain, Daniel G Batton
The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective...
April 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28407825/-effect-of-pregnancy-induced-hypertension-syndrome-on-complications-in-very-low-birth-weight-preterm-infants
#10
Song-Zhou Xu, Xiao-Yan Hu, Fang Zhao, Yu-Xin Zhou, Shuang-Chuan Zhang
OBJECTIVE: To study the effect of pregnancy-induced hypertension syndrome (PIH) on complications in very low birth weight (VLBW) preterm infants. METHODS: The VLBW preterm infants were enrolled as research subjects, and according to the presence or absence of PIH in their mothers, they were divided into PIH group and non- PIH group. The incidence of major complications and length of hospital stay were compared between the two groups. RESULTS: There were no significant differences between the two groups in gestational age, birth weight, sex, incidence rate of maternal diabetes, and use of antepartum hormone...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28407656/high-blood-pressure-during-pregnancy-is-not-a-protective-factor-for-preterm-infants-with-very-low-birth-weight-a-case-control-study
#11
Annibal Tagliaferri Sabino, Eduardo de Souza, Ana Lucia Goulart, Adriana Martins de Lima, Nelson Sass
Objective To evaluate whether the presence of maternal blood pressure reduces the risks of morbidity, perinatal mortality and morbidity at 24 months of age in very low birth weight infants (VLBWIs) compared with a control group. Methods A retrospective, observational, case-control study. Total 49 VLBWIs were allocated to the study group, called the maternal arterial hypertension group (AHG), and matched with 44 in the control group (CG). The infants were assessed during hospitalization and at 12 and 24 months corrected age at a specialized clinic...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28396833/activation-of-ppar%C3%AE-by-baicalin-attenuates-pulmonary-hypertension-in-an-infant-rat-model-by-suppressing-hmgb1-rage-signaling
#12
Zhenjie Chen, Qiuxia Wang
Pulmonary hypertension (PH) is a vascular disease, and proinflammatory factors are strongly implicated in its pathogenesis, causing right ventricular (RV) hypertrophy and heart failure. Baicalin exhibits potent anti-inflammation activity. This study aimed to investigate the curative effects of baicalin in an infant rodent model of PH and to further explore the underlying mechanisms. A PH model in infant rats was induced by hypoxia and the resulting rats were administered baicalin in incremental dosages. Invasive hemodynamic methods were used to measure mean pulmonary arterial pressure (mPAP) and RV end-diastolic pressure (RVEDP)...
April 2017: FEBS Open Bio
https://www.readbyqxmd.com/read/28389079/safety-and-tolerability-of-subcutaneous-treprostinil-in-newborns-with-congenital-diaphragmatic-hernia-and-life-threatening-pulmonary-hypertension
#13
E Carpentier, S Mur, E Aubry, L Pognon, T Rakza, F Flamein, D Sharma, P Tourneux, L Storme
BACKGROUND: Prolonged pulmonary hypertension (PH) is highly predictive for pulmonary morbidity and death in infants with congenital diaphragmatic hernia (CDH). OBJECTIVES: To report the effects and tolerability of subcutaneous treprostinil in newborns with severe CDH and late life-threatening PH. METHODS: We recorded clinical and echocardiography data before and after starting subcutaneous treprostinil, on patients with severe CDH and late PH, refractory to inhaled nitric oxide and oral sildenafil...
March 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28383537/in-hospital-outcomes-of-premature-infants-with-severe-bronchopulmonary-dysplasia
#14
W Jackson, C P Hornik, J A Messina, K Guglielmo, A Watwe, G Delancy, A Valdez, T MacArthur, S Peter-Wohl, P B Smith, V N Tolia, M M Laughon
OBJECTIVE: To characterize in-hospital outcomes of premature infants diagnosed with severe bronchopulmonary dysplasia (BPD). STUDY DESIGN: Retrospective cohort study including premature infants with severe BPD discharged from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2015. RESULTS: There were 10 752 infants with severe BPD, and 549/10 752 (5%) died before discharge. Infants who died were more likely to be male, small for gestational age, have received more medical interventions and more frequently diagnosed with surgical necrotizing enterocolitis, culture-proven sepsis and pulmonary hypertension following 36 weeks of postmenstrual age compared with survivors...
April 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28383430/timing-of-surgical-ligation-and-morbidities-in-very-low-birth-weight-infants
#15
COMPARATIVE STUDY
YoungAh Youn, Cheong-Jun Moon, Jae-Young Lee, Cheul Lee, In Kyung Sung
The present study examined whether early patent ductus arteriosus (PDA) surgical ligation at ≤2 weeks of life was associated with increased morbidities and mortality in very low birth weight infants (VLBWIs) who were diagnosed with hemodynamically significant (hs) PDA. Between December 2013 and December 2015, a total of 407 VLBWIs were admitted, of whom 145 (35.6%) infants were diagnosed with an hs PDA. The clinical data for these infants were retrospectively collected for analysis. Among the 145 VLBWIs with an hs PDA, 58 (40%) infants had surgical ligation for PDA; of these, 29 (50%) infants had early ligation (EL; ligation at ≤2 weeks of life) and 29 (50%) infants had late ligation (LL; ligation at ≥2 weeks of life)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28382839/abnormal-muscularization-of-intra-acinar-pulmonary-arteries-in-2-cases-presenting-as-sudden-infant-death-sids
#16
Zainun Khairul, Hope Kirsten, Andrew G Nicholson, Marta C Cohen
Abnormal muscularization of acinar arteries is the hallmark of persistent pulmonary hypertension of newborn (PPHN), an uncommon disease with high rate of morbidity and mortality. PPHN presents with signs of respiratory distress immediately following birth. We herein report 2 cases presenting as a witnessed sudden unexpected death in the late neonatal period, preceded by respiratory deterioration and in whom the presence of abnormal muscularization of the acinar pulmonary arteries was reminiscent of PPHN. The significance of this report is twofold: to increase the awareness among pediatricians and pathologists of this feature that can present in some cases of sudden unexpected death in infancy/Sudden Infant Death Syndrome (SIDS), and to highlight the importance of performing a thorough autopsy in order to identify the abnormality...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28374415/biventricular-function-on-early-echocardiograms-in-neonatal-hypoxic-ischemic-encephalopathy
#17
Sanjeev Aggarwal, Girija Natarajan
AIM: To compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic-ischemic encephalopathy (HIE) undergoing a)therapeutic hypothermia (TH) b) normothermia and c) normal controls. METHODS: This was a single center retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA...
April 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28373920/pulmonary-arteriovenous-malformation-causing-systemic-hypoxemia-in-early-infancy
#18
V Aggarwal, D M Khan, J F Rhodes
Pulmonary arteriovenous malformation (AVM) is not routinely appreciated during the standard echocardiogram to assess for structural abnormalities or pulmonary hypertension. The distal pulmonary AVM is suspected only if an injection of agitated saline is performed and late entry of particles is appreciated in the left heart structures. A large or complex pulmonary AVM can result in significant right-to-left shunting and consequential systemic hypoxemia in the presence or absence of pulmonary hypertension. For direct visualization of the pulmonary AVM, computerized tomography (CT) scan is the procedure of choice...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28342684/persistent-pulmonary-hypertension-of-the-newborn
#19
REVIEW
Mamta Fuloria, Judy L Aschner
Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography...
March 23, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28338487/the-evolution-of-disease-chronic-lung-disease-of-infancy-and-pulmonary-hypertension
#20
Michael C Tracy, David N Cornfield
PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) or chronic lung disease of infancy BPD was originally described 50 years ago, in 1967 by Northway et al. This article possesses two fundamental objectives to provide: a brief historical perspective on BPD; and an update relative to current notions of epidemiology, pathophysiology, evaluation, and clinical management of BPD complicated by vascular disease. The review highlights areas of consensus and ongoing uncertainty. RECENT FINDINGS: The clinical cause and presentation of infants with BPD has evolved over the past several decades...
June 2017: Current Opinion in Pediatrics
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