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PPHN

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11 papers 0 to 25 followers Persistent pulmonary hypertension of the newborn
https://www.readbyqxmd.com/read/27502103/bosentan-as-adjunctive-therapy-for-persistent-pulmonary-hypertension-of-the-newborn-results-of-the-randomized-multicenter-placebo-controlled-exploratory-trial
#1
Robin H Steinhorn, Jeffrey Fineman, Andjela Kusic-Pajic, Peter Cornelisse, Martine Gehin, Pegah Nowbakht, Christine M Pierce, Maurice Beghetti
OBJECTIVE: To evaluate the efficacy, safety, and pharmacokinetics of the endothelin receptor antagonist bosentan as adjunctive therapy for neonates with persistent pulmonary hypertension of the newborn (PPHN). STUDY DESIGN: This was a phase 3, multicenter, randomized, placebo-controlled exploratory trial (FUTURE-4). Eligible patients were >34 weeks gestation, <7 days old, receiving inhaled nitric oxide (iNO) treatment (≥4 hours), and had persistent respiratory failure (oxygenation index [OI] ≥12)...
October 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27535894/endothelin-receptor-antagonists-for-persistent-pulmonary-hypertension-in-term-and-late-preterm-infants
#2
REVIEW
Kiran More, Gayatri K Athalye-Jape, Shripada C Rao, Sanjay K Patole
BACKGROUND: Endothelin, a powerful vasoconstrictor, is one of the mediators in the causation of persistent pulmonary hypertension of the newborn (PPHN). Theoretically, endothelin receptor antagonists (ETRA) have the potential to improve the outcomes of infants with PPHN. OBJECTIVES: To assess the efficacy and safety of ETRA in the treatment of PPHN in full-term, post-term and late preterm infants.To assess the efficacy and safety of selective ETRAs (which block only the ETA receptors) and non-selective ETRAs (which block both ETA and ETB receptors) separately...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27251312/advances-in-neonatal-pulmonary-hypertension
#3
Robin H Steinhorn
Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay...
2016: Neonatology
https://www.readbyqxmd.com/read/27053698/pulmonary-hypertension-associated-with-acute-or-chronic-lung-diseases-in-the-preterm-and-term-neonate-and-infant-the-european-paediatric-pulmonary-vascular-disease-network-endorsed-by-ishlt-and-dgpk
#4
Anne Hilgendorff, Christian Apitz, Damien Bonnet, Georg Hansmann
Persistent pulmonary hypertension of the newborn (PPHN) is the most common neonatal form and mostly reversible after a few days with improvement of the underlying pulmonary condition. When pulmonary hypertension (PH) persists despite adequate treatment, the severity of parenchymal lung disease should be assessed by chest CT. Pulmonary vein stenosis may need to be ruled out by cardiac catheterisation and lung biopsy, and genetic workup is necessary when alveolar capillary dysplasia is suspected. In PPHN, optimisation of the cardiopulmonary situation including surfactant therapy should aim for preductal SpO2between 91% and 95% and severe cases without post-tricuspid-unrestrictive shunt may receive prostaglandin E1 to maintain ductal patency in right heart failure...
May 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27043088/pulmonary-hypertension-in-the-premature-infant-a-challenging-comorbidity-in-a-vulnerable-population
#5
Michael Glenn O'Connor, David N Cornfield, Eric D Austin
PURPOSE OF REVIEW: This review is written from the perspective of the pediatric clinician involved in the care of premature infants at risk for pulmonary hypertension. The main objective is to better inform the clinician in the diagnosis and treatment of pulmonary hypertension in premature infants by reviewing the available relevant literature and focusing on the areas for which there is the greatest need for continued research. RECENT FINDINGS: Continued knowledge regarding the epidemiology of pulmonary hypertension in the premature infant population has aided better diagnostic screening algorithms...
June 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/26778236/pharmacologic-strategies-in-neonatal-pulmonary-hypertension-other-than-nitric-oxide
#6
REVIEW
Satyan Lakshminrusimha, Bobby Mathew, Corinne L Leach
Inhaled nitric oxide (iNO) is approved for use in persistent pulmonary hypertension of the newborn (PPHN) but does not lead to sustained improvement in oxygenation in one-third of patients with PPHN. Inhaled NO is less effective in the management of PPHN secondary to congenital diaphragmatic hernia (CDH), extreme prematurity, and bronchopulmonary dysplasia (BPD). Intravenous pulmonary vasodilators such as prostacyclin, alprostadil, sildenafil, and milrinone have been successfully used in PPHN resistant to iNO...
April 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/26751417/towards-rational-use-of-inhaled-nitric-oxide-in-preterm-babies
#7
EDITORIAL
Nick Evans
No abstract text is available yet for this article.
February 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/26490498/sildenafil-in-term-and-premature-infants-a-systematic-review
#8
REVIEW
Krystle M Perez, Matthew Laughon
PURPOSE: Numerous medications are used off-label in term and premature infants, with limited safety or efficacy data. Although sildenafil is approved by the US Food and Drug Administration for the treatment of pulmonary hypertension in adults, it is not approved for use in children. However, sildenafil use in term and premature infants with pulmonary hypertension is increasing. The goal of this study was to review controlled trials evaluating the efficacy of sildenafil use in: (1) term infants with pulmonary hypertension; (2) premature infants at risk for developing bronchopulmonary dysplasia (BPD); and (3) premature infants with BPD-associated pulmonary hypertension...
November 1, 2015: Clinical Therapeutics
https://www.readbyqxmd.com/read/26368790/b-type-natriuretic-peptide-biomarker-of-persistent-pulmonary-hypertension-of-the-newborn
#9
Nishant Shah, Girija Natarajan, Sanjeev Aggarwal
OBJECTIVE: We assessed the utility of plasma B-type natriuretic peptide (BNP) in infants with persistent pulmonary hypertension of the newborn (PPHN) in the prediction of inhaled nitric oxide (iNO) requirement. METHODS: This prospective study involved neonates (gestational age ≥ 34 weeks) with PPHN and confirmatory echocardiographic findings. Plasma BNP was assayed once within 12 hours of meeting criteria for iNO requirements and twice every 24 to 48 hours thereafter...
September 2015: American Journal of Perinatology
https://www.readbyqxmd.com/read/26070575/inhaled-therapies-for-pulmonary-hypertension
#10
REVIEW
Nicholas S Hill, Ioana R Preston, Kari E Roberts
The inhaled route has a number of attractive features for treatment of pulmonary hypertension, including delivery of drug directly to the target organ, thus enhancing pulmonary specificity and reducing systemic adverse effects. It can also improve ventilation/perfusion matching by dilating vessels supplying ventilated regions, thus improving gas exchange. Furthermore, it can achieve higher local drug concentrations at a lower overall dose, potentially reducing drug cost. Accordingly, a number of inhaled agents have been developed to treat pulmonary hypertension...
June 2015: Respiratory Care
https://www.readbyqxmd.com/read/25765845/diagnosis-and-management-of-persistent-pulmonary-hypertension-of-the-newborn
#11
REVIEW
Perraju Bendapudi, Gopinath Gangadhara Rao, Anne Greenough
Persistent pulmonary hypertension of new born (PPHN) is associated with mortality and morbidity; it may be idiopathic or secondary to a number of conditions. The mainstay of diagnosis and to exclude structural abnormalities is echocardiography. Brain type natriuretic peptide (BNP) levels are elevated in PPHN, but are insufficiently sensitive to contribute to routine diagnosis. Management includes improving oxygenation by optimising lung volume by ventilatory techniques and/or surfactant and administering pulmonary vasodilator agents...
June 2015: Paediatric Respiratory Reviews
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