Updates on Management for Acute and Chronic Phenotypes of Neonatal Pulmonary Hypertension - 24/07/20

Doi : 10.1016/j.clp.2020.05.006

Jessica Lauren Ruoss, MD ^a, Danielle R. Rios, MD, MS ^b, Philip T. Levy, MD ^c,^d,^⁎
^a Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
^b Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA
^c Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA
^d Department of Pediatrics, Harvard Medical School, Boston, MA, USA

^∗Corresponding author. Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Hunnewell 436, Boston, MA 02115.Division of Newborn MedicineBoston Children’s Hospital300 Longwood AvenueHunnewell 436BostonMA02115

Résumé

Neonatal pulmonary hypertension is a heterogeneous disease in term and preterm neonates. It is characterized by persistent increase of pulmonary artery pressures after birth (acute) or an increase in pulmonary artery pressures after approximately 4 weeks of age (chronic); both phenotypes result in exposure of the right ventricle to sustained high afterload. In-depth clinical assessment plus echocardiographic measures evaluating pulmonary blood flow, pulmonary vascular resistance, pulmonary capillary wedge pressure, and myocardial contractility are needed to determine the cause and provide individualized targeted therapies. This article summarizes the causes, risk factors, hemodynamic assessment, and management of neonatal pulmonary hypertension.

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Keywords : Pulmonary hypertension, Neonatology, Echocardiography, Right ventricular function