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pulmonary hypertension in infants

Kai König, Katelyn J Guy, Claudia A Nold-Petry, Charles P Barfield, Geraldine Walsh, Sandra M Drew, Alex Veldman, Marcel F Nold, Dan M Casalaz
Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28 weeks gestation and still inpatients at 36 weeks corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Jason Gien, Nancy Tseng, Gregory J Seedorf, Katherine Kuhn, Steven H Abman
Bronchopulmonary dysplasia (BPD) is the chronic lung disease associated with premature birth, characterized by impaired vascular and alveolar growth. In neonatal rats bleomycin decreases lung growth and causes pulmonary hypertension (PH), which is poorly responsive to nitric oxide. In the developing lung, through rho-kinase (ROCK) activation, ET-1 impairs endothelial cell function, however, whether ET-1-ROCK interactions contribute to impaired vascular and alveolar growth in experimental BPD is unknown. Neonatal rats were treated daily with intra-peritoneal bleomycin with and without selective ETA (BQ123/BQ610) and ETB (BQ788) receptor blockers, non-selective ET receptor blocker (ETRB) (bosentan) or fasudil (ROCK inhibitor)...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Michael Khoury, Juan Pablo Sandoval, Lars Grosse-Wortmann, Edgar Jaeggi, Rajiv R Chaturvedi
A 33-day-old infant with obstructed cor triatriatum sinister and partial anomalous pulmonary venous drainage presented with respiratory distress and fever. Her suprasystemic pulmonary hypertension was relieved by opening the connection to the right atrium using balloon atrial septoplasty and septostomy, and to the inferior chamber using balloon dilation of a fenestration in the dividing membrane. This enabled extubation and discharge, with elective surgical repair at 2 months. To our knowledge, this is the youngest patient to receive a catheter intervention for obstructed cor triatriatum sinister, providing relief of pulmonary hypertension and postponement of surgical repair...
July 15, 2016: Canadian Journal of Cardiology
Kirsten Rowcliff, Koert de Waal, Abdel-Latif Mohamed, Tejasvi Chaudhari
: Noradrenaline (NA) is beneficial in the treatment of term newborns with cardiovascular compromise due to sepsis or pulmonary hypertension, but experiences with NA in preterm infants are limited. The aim of this study is to describe the efficacy and safety of NA in preterm infants. Patient records of preterm infants ≤32 weeks' gestation admitted to two hospitals between 2004 and 2015 and who received NA were reviewed for perinatal morbidities and mortality. Clinical details were collected at the time of NA use, and response on blood pressure, perfusion and oxygenation was documented as well as possible side effects...
October 15, 2016: European Journal of Pediatrics
Luke R Putnam, Kuojen Tsao, Francesco Morini, Pamela A Lally, Charles C Miller, Kevin P Lally, Matthew T Harting
Importance: Inhaled nitric oxide (iNO) is an expensive, commonly used therapy among patients with congenital diaphragmatic hernia (CDH); however, data to support its ongoing use in this patient population are lacking. Objective: To describe the spectrum of iNO use among patients with CDH and its association with pulmonary hypertension (pHTN) and mortality. Design, Setting, and Participants: A review was conducted of prospectively collected patient data in the Congenital Diaphragmatic Hernia Study Group registry between January 1, 2007, and December 31, 2014, from 70 participating centers in 13 countries...
October 10, 2016: JAMA Pediatrics
Patrick C Donnelly, Rebecca M Sutich, Ryan Easton, Oluwatunmise A Adejumo, Todd A Lee, Latania K Logan
BACKGROUND: Ceftriaxone is a third-generation cephalosporin with broad-spectrum activity against both Gram-positive and Gram-negative bacteria. Despite its effectiveness, its use for the treatment of infections in neonatal patients has been limited because of concern about its potential toxicity. OBJECTIVE: Our aim was to review the literature for an association between ceftriaxone and cardiopulmonary events, hyperbilirubinemia, and pseudolithiasis among neonates...
October 7, 2016: Paediatric Drugs
Joseph M Collaco, Gul H Dadlani, Melanie K Nies, Jenny Leshko, Allen D Everett, Sharon A McGrath-Morrow
BACKGROUND: Pulmonary hypertension (PH) is a significant cause of morbidity in preterm infants, but no screening guidelines exist. We sought to identify risk factors and clinical outcomes associated with PH in preterm infants to develop a PH risk score. METHODS: Retrospective analysis of two separate populations of preterm infants (NICU cohort n = 230; Clinic registry n = 580). RESULTS: 8.3% of the NICU cohort had PH after 4 weeks of age, while 14...
2016: PloS One
Mostafa Behjati-Ardakani, Mohammad Golshan, Sedigheh Akhavan-Karbasi, Seyed-Masood Hosseini, Mohammad-Amin Behjati-Ardakani, Mohammadtaghi Sarebanhassanabadi
BACKGROUND: Atrial septal defect (ASD) is a common congenital heart disease. OBJECTIVES: The aim of this study was to assess the clinical course of ASD, as well as its frequency of spontaneous closure and regression of diameter. METHODS: In a study conducted from 2000 to 2011, 192 consecutive patients with an isolated ASD were followed up regularly with periodic echocardiographic evaluations according to a standardized protocol. The study was conducted in two series of patients: infants and children and adults...
August 2016: Iranian Journal of Pediatrics
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
U Haque, C Stiver, B K Rivera, B Richards, N Ma, C L Cua, C V Smith, C H Backes
OBJECTIVE: Right ventricular (RV) performance among infants with bronchopulmonary dysplasia (BPD) remains poorly understood. We tested the hypothesis that myocardial deformation imaging (MDI) strain and strain rate would allow for differentiation between infants with severe and milder forms of BPD, independent of tissue Doppler imaging (TDI) and superior to conventional echocardiographic measurements. STUDY DESIGN: Infants with various severities of BPD (11 with none or mild, 13 with moderate and 10 with severe) underwent conventional echocardiography, TDI and MDI assessments at >36 weeks of corrected gestational age...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Eiji Hirakawa, Satoshi Ibara, Takuya Tokuhisa, Yoshinobu Maede, Takako Kuwahara, Chie Ishihara, Hiroyuki Noguchi, Yoshiki Naitou, Masakatsu Yamamoto, Masaya Kibe, Tsuyoshi Yamamoto, Tomonori Kurimoto, Masato Kamitomo, Kazutoshi Cho, Hisanori Minakami
BACKGROUND: There have been few reports regarding outcomes after extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. METHODS: A review of 61 neonates with ECMO through January 1995 at a single center was performed. ECMO was used in neonates with oxygenation index > 20 after conventional treatments. Background factors, such as etiology, vascular access mode (veno-venous [VV] or veno-arterial [VA]), number of days with ECMO, and early ECMO (within 24 hours after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD)...
October 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Sae Yun Kim, Seung Han Shin, Han-Suk Kim, Young Hwa Jung, Ee-Kyung Kim, Jung-Hwan Choi
OBJECTIVE: To describe the clinical course and risk factors for pulmonary arterial hypertension (PAH) after ibuprofen treatment to close patent ductus arteriosus. STUDY DESIGN: All neonates weighing < 1500 g at birth who received ibuprofen to close patent ductus arteriosus and were admitted to Seoul National University Children's Hospital's neonatal intensive care unit in 2010-2014 were eligible for this study. The study population was divided into the PAH and non-PAH groups, and medical records were retrospectively reviewed...
September 28, 2016: Journal of Pediatrics
Yan-Ping Xu
OBJECTIVES: Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disorder affecting preterm infants. We studied the factors and echocardiographic evidence of early pulmonary hypertension (PH) associated with moderate or severe BPD. METHODS: We retrospectively reviewed preterm infants who were born at <32 weeks gestation and admitted to the neonatal intensive care unit at the Children's Hospital of Zhejiang University School of Medicine between July 2013 and July 2015...
2016: Global Pediatric Health
Douglas Bush, Steven H Abman, Csaba Galambos
OBJECTIVES: To determine the frequency of histologic features of impaired lung vascular and alveolar development and to identify the presence of intrapulmonary bronchopulmonary anastomoses (IBA) in infants and children who died with Down syndrome. STUDY DESIGN: A retrospective review of autopsy reports and lung histology from 13 children with Down syndrome (ages: 0-8 years) was performed. Histologic features of abnormal lung development were identified and semiquantified, including the presence of IBA...
September 22, 2016: Journal of Pediatrics
S Herbert, R Tulloh
Pulmonary hypertension (PH) secondary to bronchopulmonary dysplasia (BPD) in infants remains a serious concern and continues to cause significant morbidity despite improvements in both quality of life and survival for patients. One of the potential agents that might help is sildenafil citrate, a phosphodiesterase-V inhibitor used a first line therapy for idiopathic PH. However, only limited evidence exists for its use as either monotherapy or part of a combination approach towards the management of PH in BPD...
September 21, 2016: Early Human Development
J Zimmer, T Takahashi, A D Hofmann, Prem Puri
PURPOSE: High mortality and morbidity in infants born with congenital diaphragmatic hernia (CDH) are attributed to pulmonary hypoplasia and pulmonary hypertension (PH). Forkhead box (Fox) transcription factors are known to be crucial for cell proliferation and homeostasis. FoxF1 is essential for lung morphogenesis, vascular development, and endothelial proliferation. Mutations in FoxF1 and also the Fox family member FoxC2 have been identified in neonates with PH. In human and experimental models of arterial PH, the Fox protein FoxO1 was found to be downregulated...
September 23, 2016: Pediatric Surgery International
Kathryn Browning Carmo, Tracey Lutz, Andrew Berry, Martin Kluckow, Nick Evans
AIM: To determine the role of clinician performed ultrasound (CPU) during the retrieval and transport of critically ill term and near term newborns. METHODS: A neonatologist with portable ultrasound accompanied a sample of newborn retrievals to perform cardiac and cerebral ultrasound before and after transportation. RESULTS: A total of fifty-five babies were studied. Median birthweight: 3350 g (2220-5030 g). CPU led to a change in the planned receiving hospital in ten babies...
September 15, 2016: Acta Paediatrica
Praveen Chandrasekharan, Rafal Kozielski, Vasantha H S Kumar, Munmun Rawat, Veena Manja, Changxing Ma, Satyan Lakshminrusimha
Inhaled nitric oxide (iNO) is being increasingly used in preterm infants < 34 weeks with hypoxemic respiratory failure (HRF) and/or pulmonary hypertension (PH). Objective To evaluate the risk factors, survival characteristics, and lung histopathology in preterm infants with PH/HRF. Methods Retrospective chart review was conducted to determine characteristics of 93 preterm infants treated with iNO in the first 28 days and compared with 930 matched controls. Factors associated with survival with preterm HRF and smooth muscle actin from nine autopsies were evaluated...
September 14, 2016: American Journal of Perinatology
Yves Wyss, Daniel Quandt, Roland Weber, Brian Stiasny, Benedikt Weber, Walter Knirsch, Oliver Kretschmar
AIMS: This study set out to assess indications, feasibility, complications, and clinical outcome of percutaneous transcatheter device closure of atrial septal defects (ASDs) in infants with a bodyweight below 10 kg. METHODS AND RESULTS: Retrospective single center chart and echocardiography review study from 8/2005-12/2013. Twenty-eight children with ASD (13 female) with a median age of 1.15 years (0.2-2.8) and a median weight of 7.2 kg (4.5-9.9) were analyzed...
September 13, 2016: Journal of Interventional Cardiology
Carmen Mesas Burgos, Agnes Modée, Elin Öst, Björn Frenckner
INTRODUCTION: Despite improvements of neonatal intensive care, mortality among patients born with congenital diaphragmatic hernia (CDH), remains high, and there is a significant late mortality in this cohort. OBJECTIVE: The aim of this study was to evaluate the causes of death among 251 consecutive CDH patients treated at our institution during the last 26years period. METHODS: Retrospective review of all causes of death between 1990 and 2015 of the CDH cohort prospectively collected in a database...
September 5, 2016: Journal of Pediatric Surgery
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