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pulmonary hypertension in infants

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https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#1
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28641750/predicting-outcomes-in-congenital-diaphragmatic-hernia
#2
Oluwatomilayo Daodu, Mary E Brindle
Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are evidence-based tools that combine multiple predictors to estimate the probability that a particular outcome in an individual patient will occur. In CDH, a suitable clinical prediction rule can stratify high- and low-risk populations and provide the ability to tailor management strategies based on severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28637627/pulmonary-arterial-resistance-and-compliance-in-preterm-infants
#3
Seigo Okada, Jun Muneuchi, Yusaku Nagatomo, Mamie Watanabe, Chiaki Iida, Hiromitsu Shirouzu, Ryohei Matsuoka, Kunitaka Joo
BACKGROUND: Preterm birth is known to be associated with an increased risk of pulmonary arterial hypertension, although how preterm birth influences pulmonary hemodynamics has not been fully understood. Pulmonary arterial resistance (Rp) and compliance (Cp) are important factors to assess the pulmonary circulation. The purpose of this study is to clarify the relationship between Rp and Cp in preterm infants. METHODS: We performed cardiac catheterization in 96 infants (50 males) with ventricular septal defect, and compared pulmonary hemodynamic parameters including Rp and Cp between preterm and full-term infants...
June 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28629243/effect-of-therapeutic-hypothermia-on-myocardial-dysfunction-in-term-neonates-with-perinatal-asphyxia-%C3%A2-a-randomized-controlled-trial
#4
Rakesh Kotha, B Vishnu Bhat, B Adhisivam, P Ajith
OBJECTIVE: To evaluate the effect of therapeutic hypothermia on myocardial dysfunction in term neonates with perinatal asphyxia. MATERIAL AND METHODS: This Randomized Controlled Trial conducted in a tertiary care teaching hospital, south India included 120 newborns with perinatal asphyxia who were randomized to 2 groups (therapeutic hypothermia and normothermia). Cardiac enzyme profile changes between groups were assessed at 0, 24, 72 hrs CPK-MB and troponin I levels were estimated by immune inhibition and quantitative immunochromatography methods respectively...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28617427/mortality-among-infants-with-evolving-bronchopulmonary-dysplasia-increases-with-major-surgery-and-with-pulmonary-hypertension
#5
L B DeVries, R J Heyne, C Ramaciotti, L S Brown, M A Jaleel, V S Kapadia, P J Burchfield, L P Brion
OBJECTIVE: To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ⩾28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery. STUDY DESIGN: Single institution retrospective birth cohort of preterm infants with gestational age (GA) 23(0/7) to 36(6/7) weeks, and evolving BPD delivered between 2001 and 2014. Surgery was classified as minor or major using published criteria...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28609431/polymorphisms-in-urea-cycle-enzyme-genes-are-associated-with-persistent-pulmonary-hypertension-of-the-newborn
#6
Dinushan C Kaluarachchi, Caitlin J Smith, Jonathan M Klein, Jeffrey C Murray, John M Dagle, Kelli K Ryckman
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by elevated pulmonary vascular resistance. Endogenous nitric oxide is critical for regulation of pulmonary vascular resistance. Nitric oxide is generated from L -arginine, supplied by the urea cycle (UC). We hypothesized that polymorphisms in UC enzyme genes and low concentrations of UC intermediates are associated with PPHN. METHODS: We performed a family based candidate gene analysis to study 48 single nucleotide polymorphisms (SNPs) in 6 UC enzyme genes...
June 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28600701/the-impact-of-exposure-to-antidepressant-medications-during-pregnancy-on-neonatal-outcomes-a-review-of-retrospective-database-cohort-studies
#7
REVIEW
Casey R Tak, Kathleen M Job, Katie Schoen-Gentry, Sarah C Campbell, Patrick Carroll, Maged Costantine, Diana Brixner, Angela K Birnbaum, Catherine M T Sherwin
INTRODUCTION: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors...
June 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28552078/comparison-of-the-therapeutic-effects-and-side-effects-of-tadalafil-and-sildenafil-after-surgery-in-young-infants-with-pulmonary-arterial-hypertension-due-to-systemic-to-pulmonary-shunts
#8
Mohammad Reza Sabri, Hamid Bigdelian, Mohsen Hosseinzadeh, Alireza Ahmadi, Mehdi Ghaderian, Mohammad Shoja
Young children with CHD and large systemic-to-pulmonary shunts eventually develop pulmonary hypertension. At present, phosphodiesterase type-5 inhibitors such as sildenafil have been used to control pulmonary pressure before and after cardiac surgery. Recently, tadalafil has been utilised in older children with similar efficacy, but it has been used to a lesser extent in young infants. From April, 2015 to June, 2016, 42 patients aged 3-24 months with a large septal defect and pulmonary arterial hypertension were randomly divided into two equal groups: one group received oral sildenafil (1-3 mg/kg/day every 8 hours), whereas the other group received oral tadalafil (1 mg/kg once a day) from 7-10 days before surgery to 3-4 weeks after surgery...
May 29, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28533687/pulmonary-hypertension-and-vasculopathy-in-incontinentia-pigmenti-a-case-report
#9
Abduljabbar Alshenqiti, Marwan Nashabat, Hissah AlGhoraibi, Omar Tamimi, Majid Alfadhel
Incontinentia pigmenti (IP; Bloch-Sulzberger syndrome) is a rare, genetic syndrome inherited as an X-linked dominant trait. It primarily affects female infants and is lethal in the majority of males during fetal life. The clinical findings include skin lesions, developmental defects, and defects of the eyes, teeth, skeletal system, and central nervous system. Cardiovascular complications of this disease in general, and pulmonary hypertension in particular, are extremely rare. This report describes the case of a 3-year-old girl with IP complicated by pulmonary arterial hypertension...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28521893/pulmonary-hypertension-in-infants-children-and-young-adults
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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